{"id":3669,"date":"2026-08-12T09:27:30","date_gmt":"2026-08-12T09:27:30","guid":{"rendered":"https:\/\/jonathan.rcm-test-web.co.za\/Ethiopian-Association\/?page_id=3669"},"modified":"2026-08-12T09:30:37","modified_gmt":"2026-08-12T09:30:37","slug":"memebership-and-business-application","status":"publish","type":"page","link":"https:\/\/jonathan.rcm-test-web.co.za\/Ethiopian-Association\/memebership-and-business-application\/","title":{"rendered":"Memebership And Business Application"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"3669\" class=\"elementor elementor-3669\" data-elementor-post-type=\"page\">\n\t\t\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-d8ec198 e-con-full bg e-flex e-con e-parent\" data-id=\"d8ec198\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;background_motion_fx_motion_fx_scrolling&quot;:&quot;yes&quot;,&quot;background_motion_fx_scale_effect&quot;:&quot;yes&quot;,&quot;background_motion_fx_scale_direction&quot;:&quot;in-out&quot;,&quot;background_motion_fx_scale_speed&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:2,&quot;sizes&quot;:[]},&quot;background_motion_fx_scale_range&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:{&quot;start&quot;:20,&quot;end&quot;:80}},&quot;background_motion_fx_devices&quot;:[&quot;desktop&quot;,&quot;tablet&quot;,&quot;mobile&quot;]}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d0bea0c elementor-invisible elementor-widget elementor-widget-heading\" data-id=\"d0bea0c\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInUp&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Business Application\n<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-8867444 e-con-full e-flex e-con e-parent\" data-id=\"8867444\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-15e5142 e-con-full e-flex e-con e-child\" data-id=\"15e5142\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-420ca55 eael-gravity-form-button-custom elementor-widget elementor-widget-eael-gravity-form\" data-id=\"420ca55\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"eael-gravity-form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t<div class=\"eael-contact-form eael-gravity-form placeholder-hide eael-contact-form-align-default\">\n\t\t        <script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_12' style='display:none'>\n                        <div class='gform_heading'>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_12'  action='\/Ethiopian-Association\/wp-json\/wp\/v2\/pages\/3669' data-formid='12' novalidate><input name=\"geolocation_submitter_location\" id=\"geolocation_submitter_location\" type=\"hidden\" data-js=\"geolocation_submitter_location\" value=\"\" \/>\n                        <div class='gform-body gform_body'><div id='gform_fields_12' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_12_47\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Membership Application<\/div><div id=\"field_12_49\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_49'><span class='gform-field-label__text'>Full Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_49' id='input_12_49' type='text' value='' class='large'    placeholder='Full Name' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_50\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_50'><span class='gform-field-label__text'>Last Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_50' id='input_12_50' type='text' value='' class='large'    placeholder='Last Name' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_51\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_51'><span class='gform-field-label__text'>Residential Address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_51' id='input_12_51' type='text' value='' class='large'    placeholder='Residential Address' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_52\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_52'><span class='gform-field-label__text'>Country<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_52' id='input_12_52' type='text' value='' class='large'    placeholder='Country' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_53\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_53'><span class='gform-field-label__text'>City<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_53' id='input_12_53' type='text' value='' class='large'    placeholder='City' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_54\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-international gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_54'><span class='gform-field-label__text'>Cell Number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_54' id='input_12_54' type='tel' value='' class='large'  placeholder='Cell Number' aria-required=\"true\" aria-invalid=\"false\"    \/><\/div><\/div><div id=\"field_12_55\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-international gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_55'><span class='gform-field-label__text'>Whatsapp Number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_55' id='input_12_55' type='tel' value='' class='large'  placeholder='Whatsapp Number' aria-required=\"true\" aria-invalid=\"false\"    \/><\/div><\/div><div id=\"field_12_56\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_56'><span class='gform-field-label__text'>Date Of Birth<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='Date Of Birth'\n\t\t\t\t\tid='input_12_56'\n\t\t\t\t\tclass='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_56'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\taria-required=\"true\"\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_12_56' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_12_56' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_12_56' aria-label='Date Of Birth: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/div><div id=\"field_12_57\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_57'><span class='gform-field-label__text'>Place Of Birth<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_57' id='input_12_57' type='text' value='' class='large'    placeholder='Place Of Birth' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_58\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_58'><span class='gform-field-label__text'>Gender<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_58' id='input_12_58' type='text' value='' class='large'    placeholder='Gender' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_60\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_60'><span class='gform-field-label__text'>Nationality<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_60' id='input_12_60' type='text' value='' class='large'    placeholder='Nationality' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_59\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_59'><span class='gform-field-label__text'>Age<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_59' id='input_12_59' type='text' value='' class='large'    placeholder='Age' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_61\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_61'><span class='gform-field-label__text'>Occupation<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_61' id='input_12_61' type='text' value='' class='large'    placeholder='Occupation' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_63\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_63'><span class='gform-field-label__text'>Yearly Membership Payment<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_63' id='input_12_63' type='text' value='' class='large'    placeholder='Yearly Membership Payment' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_64\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_64'><span class='gform-field-label__text'>Mother Tongue<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_64' id='input_12_64' type='text' value='' class='large'    placeholder='Mother Tongue' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_65\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_65'><span class='gform-field-label__text'>First Additional Language<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_65' id='input_12_65' type='text' value='' class='large'    placeholder='First Additional Language' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_66\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_66'><span class='gform-field-label__text'>Other Information<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_66' id='input_12_66' class='textarea small'    placeholder='Other Information'  aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_12_67\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_67'><span class='gform-field-label__text'>Province<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_67' id='input_12_67' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Province<\/option><option value='Gauteng' >Gauteng<\/option><option value='Limpopo' >Limpopo<\/option><option value='Mpumalanga' >Mpumalanga<\/option><option value='KwaZulu-Natal' >KwaZulu-Natal<\/option><option value='North West' >North West<\/option><option value='Free State' >Free State<\/option><option value='Eastern Cape' >Eastern Cape<\/option><option value='Northern Cape' >Northern Cape<\/option><option value='Western Cape' >Western Cape<\/option><\/select><\/div><\/div><fieldset id=\"field_12_68\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Gauteng<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_12_68'><div class='gchoice gchoice_12_68_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_68.1' type='checkbox'  value='City Of Tshwane'  id='choice_12_68_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_68_1' id='label_12_68_1' class='gform-field-label gform-field-label--type-inline'>City Of Tshwane<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_68_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_68.2' type='checkbox'  value='Ekurhuleni'  id='choice_12_68_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_68_2' id='label_12_68_2' class='gform-field-label gform-field-label--type-inline'>Ekurhuleni<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_68_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_68.3' type='checkbox'  value='City Of Johannesburg'  id='choice_12_68_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_68_3' id='label_12_68_3' class='gform-field-label gform-field-label--type-inline'>City Of Johannesburg<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_68_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_68.4' type='checkbox'  value='Sedibeng Midvaal'  id='choice_12_68_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_68_4' id='label_12_68_4' class='gform-field-label gform-field-label--type-inline'>Sedibeng Midvaal<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_68_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_68.5' type='checkbox'  value='West Rand'  id='choice_12_68_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_68_5' id='label_12_68_5' class='gform-field-label gform-field-label--type-inline'>West Rand<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_68_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_68.6' type='checkbox'  value='Other'  id='choice_12_68_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_68_6' id='label_12_68_6' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_69\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Limpopo<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_12_69'><div class='gchoice gchoice_12_69_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_69.1' type='checkbox'  value='Capricorn'  id='choice_12_69_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_69_1' id='label_12_69_1' class='gform-field-label gform-field-label--type-inline'>Capricorn<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_69_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_69.2' type='checkbox'  value='Mopani'  id='choice_12_69_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_69_2' id='label_12_69_2' class='gform-field-label gform-field-label--type-inline'>Mopani<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_69_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_69.3' type='checkbox'  value='Sekhukhune'  id='choice_12_69_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_69_3' id='label_12_69_3' class='gform-field-label gform-field-label--type-inline'>Sekhukhune<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_69_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_69.4' type='checkbox'  value='Vhembe'  id='choice_12_69_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_69_4' id='label_12_69_4' class='gform-field-label gform-field-label--type-inline'>Vhembe<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_69_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_69.5' type='checkbox'  value='Waterberg'  id='choice_12_69_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_69_5' id='label_12_69_5' class='gform-field-label gform-field-label--type-inline'>Waterberg<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_69_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_69.6' type='checkbox'  value='Other'  id='choice_12_69_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_69_6' id='label_12_69_6' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_70\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Mpumalanga<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_12_70'><div class='gchoice gchoice_12_70_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_70.1' type='checkbox'  value='Bushbuckridge'  id='choice_12_70_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_70_1' id='label_12_70_1' class='gform-field-label gform-field-label--type-inline'>Bushbuckridge<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_70_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_70.2' type='checkbox'  value='Nkomazi'  id='choice_12_70_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_70_2' id='label_12_70_2' class='gform-field-label gform-field-label--type-inline'>Nkomazi<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_70_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_70.3' type='checkbox'  value='Thaba Chwev'  id='choice_12_70_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_70_3' id='label_12_70_3' class='gform-field-label gform-field-label--type-inline'>Thaba Chwev<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_70_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_70.4' type='checkbox'  value='Dipaleseng'  id='choice_12_70_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_70_4' id='label_12_70_4' class='gform-field-label gform-field-label--type-inline'>Dipaleseng<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_70_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_70.5' type='checkbox'  value='Other'  id='choice_12_70_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_70_5' id='label_12_70_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_71\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>KwaZulu-Natal<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_12_71'><div class='gchoice gchoice_12_71_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_71.1' type='checkbox'  value='Amajuba'  id='choice_12_71_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_71_1' id='label_12_71_1' class='gform-field-label gform-field-label--type-inline'>Amajuba<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_71_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_71.2' type='checkbox'  value='uMzinyathi'  id='choice_12_71_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_71_2' id='label_12_71_2' class='gform-field-label gform-field-label--type-inline'>uMzinyathi<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_71_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_71.3' type='checkbox'  value='uThukela'  id='choice_12_71_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_71_3' id='label_12_71_3' class='gform-field-label gform-field-label--type-inline'>uThukela<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_71_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_71.4' type='checkbox'  value='Big 5 Hlabisa Municipality'  id='choice_12_71_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_71_4' id='label_12_71_4' class='gform-field-label gform-field-label--type-inline'>Big 5 Hlabisa Municipality<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_71_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_71.5' type='checkbox'  value='Other'  id='choice_12_71_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_71_5' id='label_12_71_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_73\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>North West<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_12_73'><div class='gchoice gchoice_12_73_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.1' type='checkbox'  value='Ditsobotla'  id='choice_12_73_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_73_1' id='label_12_73_1' class='gform-field-label gform-field-label--type-inline'>Ditsobotla<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_73_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.2' type='checkbox'  value='Kgetlengrivier'  id='choice_12_73_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_73_2' id='label_12_73_2' class='gform-field-label gform-field-label--type-inline'>Kgetlengrivier<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_73_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.3' type='checkbox'  value='Moretele'  id='choice_12_73_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_73_3' id='label_12_73_3' class='gform-field-label gform-field-label--type-inline'>Moretele<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_73_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.4' type='checkbox'  value='Moses Kotane'  id='choice_12_73_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_73_4' id='label_12_73_4' class='gform-field-label gform-field-label--type-inline'>Moses Kotane<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_73_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.5' type='checkbox'  value='Other'  id='choice_12_73_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_73_5' id='label_12_73_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_72\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Free State<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_12_72'><div class='gchoice gchoice_12_72_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_72.1' type='checkbox'  value='Fezile Dabi District Municipality'  id='choice_12_72_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_72_1' id='label_12_72_1' class='gform-field-label gform-field-label--type-inline'>Fezile Dabi District Municipality<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_72_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_72.2' type='checkbox'  value='Lejweleputswa'  id='choice_12_72_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_72_2' id='label_12_72_2' class='gform-field-label gform-field-label--type-inline'>Lejweleputswa<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_72_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_72.3' type='checkbox'  value='Mangaung Metropolitan Municipality'  id='choice_12_72_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_72_3' id='label_12_72_3' class='gform-field-label gform-field-label--type-inline'>Mangaung Metropolitan Municipality<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_72_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_72.4' type='checkbox'  value='Thabo Mofutsanyana'  id='choice_12_72_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_72_4' id='label_12_72_4' class='gform-field-label gform-field-label--type-inline'>Thabo Mofutsanyana<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_72_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_72.5' type='checkbox'  value='Other'  id='choice_12_72_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_72_5' id='label_12_72_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_74\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Eastern Cape<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_12_74'><div class='gchoice gchoice_12_74_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_74.1' type='checkbox'  value='Emalahleni'  id='choice_12_74_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_74_1' id='label_12_74_1' class='gform-field-label gform-field-label--type-inline'>Emalahleni<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_74_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_74.2' type='checkbox'  value='Joe Gqabi District'  id='choice_12_74_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_74_2' id='label_12_74_2' class='gform-field-label gform-field-label--type-inline'>Joe Gqabi District<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_74_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_74.3' type='checkbox'  value='Alfred Nzo'  id='choice_12_74_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_74_3' id='label_12_74_3' class='gform-field-label gform-field-label--type-inline'>Alfred Nzo<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_74_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_74.4' type='checkbox'  value='Blue Crane Route'  id='choice_12_74_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_74_4' id='label_12_74_4' class='gform-field-label gform-field-label--type-inline'>Blue Crane Route<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_74_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_74.5' type='checkbox'  value='Other'  id='choice_12_74_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_74_5' id='label_12_74_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_75\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Northen Cape<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_12_75'><div class='gchoice gchoice_12_75_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_75.1' type='checkbox'  value='John Taolo Gaetsewe'  id='choice_12_75_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_75_1' id='label_12_75_1' class='gform-field-label gform-field-label--type-inline'>John Taolo Gaetsewe<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_75_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_75.2' type='checkbox'  value='Pixley Ka Seme'  id='choice_12_75_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_75_2' id='label_12_75_2' class='gform-field-label gform-field-label--type-inline'>Pixley Ka Seme<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_75_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_75.3' type='checkbox'  value='Frances Baard'  id='choice_12_75_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_75_3' id='label_12_75_3' class='gform-field-label gform-field-label--type-inline'>Frances Baard<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_75_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_75.4' type='checkbox'  value='Namakwa District'  id='choice_12_75_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_75_4' id='label_12_75_4' class='gform-field-label gform-field-label--type-inline'>Namakwa District<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_75_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_75.5' type='checkbox'  value='Other'  id='choice_12_75_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_75_5' id='label_12_75_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_76\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Western Cape<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_12_76'><div class='gchoice gchoice_12_76_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_76.1' type='checkbox'  value='Cape Winelands'  id='choice_12_76_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_76_1' id='label_12_76_1' class='gform-field-label gform-field-label--type-inline'>Cape Winelands<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_76_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_76.2' type='checkbox'  value='Overberg'  id='choice_12_76_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_76_2' id='label_12_76_2' class='gform-field-label gform-field-label--type-inline'>Overberg<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_76_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_76.3' type='checkbox'  value='City Of Cape Town'  id='choice_12_76_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_76_3' id='label_12_76_3' class='gform-field-label gform-field-label--type-inline'>City Of Cape Town<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_76_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_76.4' type='checkbox'  value='Central Karoo District'  id='choice_12_76_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_76_4' id='label_12_76_4' class='gform-field-label gform-field-label--type-inline'>Central Karoo District<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_76_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_76.5' type='checkbox'  value='Other'  id='choice_12_76_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_76_5' id='label_12_76_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_12_77\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_77'><span class='gform-field-label__text'>Other<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_77' id='input_12_77' type='text' value='' class='large'    placeholder='Other' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_12_78\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Status in South Africa<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_12_78'><div class='gchoice gchoice_12_78_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.1' type='checkbox'  value='Citizen And Citizenship'  id='choice_12_78_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_78_1' id='label_12_78_1' class='gform-field-label gform-field-label--type-inline'>Citizen And Citizenship<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_78_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.2' type='checkbox'  value='Permanent Resident Non-Citizen'  id='choice_12_78_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_78_2' id='label_12_78_2' class='gform-field-label gform-field-label--type-inline'>Permanent Resident Non-Citizen<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_78_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.3' type='checkbox'  value='Refuge States'  id='choice_12_78_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_78_3' id='label_12_78_3' class='gform-field-label gform-field-label--type-inline'>Refuge States<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_78_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.4' type='checkbox'  value='Asylum Seeker'  id='choice_12_78_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_78_4' id='label_12_78_4' class='gform-field-label gform-field-label--type-inline'>Asylum Seeker<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_78_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.5' type='checkbox'  value='Other'  id='choice_12_78_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_78_5' id='label_12_78_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_12_79\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_79'><span class='gform-field-label__text'>ID Number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_79' id='input_12_79' type='text' value='' class='large'    placeholder='ID Number' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_80\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_80'><span class='gform-field-label__text'>Passport<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_80' id='input_12_80' type='text' value='' class='large'    placeholder='Passport' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_81\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_81'><span class='gform-field-label__text'>Refuge States<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_81' id='input_12_81' type='text' value='' class='large'    placeholder='Refuge States' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_82\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_82'><span class='gform-field-label__text'>Asylum Seeker Number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_82' id='input_12_82' type='text' value='' class='large'    placeholder='Asylum Seeker Number' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_83\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_83'><span class='gform-field-label__text'>Other<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_83' id='input_12_83' type='text' value='' class='large'    placeholder='Other' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_12_84\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Asylum Seeker Rejection<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_84'>\n\t\t\t<div class='gchoice gchoice_12_84_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_84' type='radio' value='Yes'  id='choice_12_84_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_84_0' id='label_12_84_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_84_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_84' type='radio' value='No'  id='choice_12_84_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_84_1' id='label_12_84_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_85\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Asylum Seeker Documents<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_85'>\n\t\t\t<div class='gchoice gchoice_12_85_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_85' type='radio' value='Vaild'  id='choice_12_85_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_85_0' id='label_12_85_0' class='gform-field-label gform-field-label--type-inline'>Vaild<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_85_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_85' type='radio' value='Over Stay'  id='choice_12_85_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_85_1' id='label_12_85_1' class='gform-field-label gform-field-label--type-inline'>Over Stay<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_12_86\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_86'><span class='gform-field-label__text'>Make Payment<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_86' id='input_12_86' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Cash' >Cash<\/option><option value='EFT' >EFT<\/option><option value='Bank Deposit' >Bank Deposit<\/option><\/select><\/div><\/div><div id=\"field_12_89\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_89'><span class='gform-field-label__text'>Upload Image Of Self<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='1073741824' \/><input name='input_89' id='input_12_89' type='file' class='large' aria-describedby=\"gfield_upload_rules_12_89\" onchange='javascript:gformValidateFileSize( this, 1073741824 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_12_89'>Max. file size: 1 GB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_12_89'><\/div> <\/div><\/div><div id=\"field_12_88\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_88'><span class='gform-field-label__text'>Proof of Address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='1073741824' \/><input name='input_88' id='input_12_88' type='file' class='large' aria-describedby=\"gfield_upload_rules_12_88\" onchange='javascript:gformValidateFileSize( this, 1073741824 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_12_88'>Max. file size: 1 GB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_12_88'><\/div> <\/div><\/div><div id=\"field_12_87\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_87'><span class='gform-field-label__text'>ID Document\/ Passport or Document of Asylum Seeker\/Refugee<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='1073741824' \/><input name='input_87' id='input_12_87' type='file' class='large' aria-describedby=\"gfield_upload_rules_12_87\" onchange='javascript:gformValidateFileSize( this, 1073741824 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_12_87'>Max. file size: 1 GB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_12_87'><\/div> <\/div><\/div><div id=\"field_12_48\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Next Of Kin<\/div><div id=\"field_12_92\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_92'><span class='gform-field-label__text'>First Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_92' id='input_12_92' type='text' value='' class='large'    placeholder='First Name' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_91\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_91'><span class='gform-field-label__text'>Last Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_91' id='input_12_91' type='text' value='' class='large'    placeholder='Last Name' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_94\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_94'><span class='gform-field-label__text'>Cell Number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_94' id='input_12_94' type='text' value='' class='large'    placeholder='Cell Number' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_93\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_93'><span class='gform-field-label__text'>Whatsapp Number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_93' id='input_12_93' type='text' value='' class='large'    placeholder='Whatsapp Number' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_12_95\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Consent<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_95.1' id='input_12_95_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_12_95_1' ><span class='gform-field-label__text'>I understand that I want to be a member of the Ethiopian Association and have read and understand the constitution. I confirm with my signature that I agree to fulfill the duties and responsibilities expected of me as any member..<\/span><\/label><input type='hidden' name='input_95.2' value='I understand that I want to be a member of the Ethiopian Association and have read and understand the constitution. I confirm with my signature that I agree to fulfill the duties and responsibilities expected of me as any member..' class='gform_hidden' \/><input type='hidden' name='input_95.3' value='7' class='gform_hidden' \/><\/div><\/fieldset><div id=\"field_12_96\" class=\"gfield gfield--type-signature gfield--input-type-signature gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_96'><span class='gform-field-label__text'>Member Signature<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><input type='hidden' value='' name='input_96' id='input_12_96_signature_filename'\/><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_12_96_Container' class='gfield_signature_container ginput_container' style='height:180px; width:300px; ' ><canvas id='input_12_96' width='300' height='180' style='border-style: Dashed; border-width: 2px; border-color: #DDDDDD; background-color:#FFFFFF; cursor: url(https:\/\/jonathan.rcm-test-web.co.za\/Ethiopian-Association\/wp-content\/plugins\/gravityformssignature\/assets\/img\/pen.cur), pointer;'><\/canvas><\/div><div id='input_12_96_toolbar' style='margin:5px 0;position:relative;height:20px;width:300px;max-width:100%;'><img id = 'input_12_96_resetbutton' src='data:image\/png;base64,iVBORw0KGgoAAAANSUhEUgAAABgAAAAYCAYAAADgdz34AAAAGXRFWHRTb2Z0d2FyZQBBZG9iZSBJbWFnZVJlYWR5ccllPAAAAtRJREFUeNrsld9rklEYx32nc7i2GulGtZg6XJbJyBeJzbGZJJVuAyFD7D8QumiG7nLXQuw6dtHN7oYwFtIgDG+2CGQtGf1grBpWIkPHaDpJZvZ95F2cqfPHRTfRgY\/H85znfb7nPc85z8sVi0XR32zcf4GmBTiOk8GWY8YSdEpwHpwG7eAA\/ABJsA3\/w5MEJOUGi8VyCUFFeCiGvlcsFvOFQqGtzK1d4Bzmr8DvDfy\/NyTgcDj6I5GIGA91YdiN4CW7RqNp83g8fZ2dna17e3v5ubm5r1tbWz8F8WH4v4PIh7oCTOumH4VCIQkGg6axsTElgkRhyoJTXq\/33srKStzpdL5KpVK0RVcxvw+Rb40KlNr09LTSbDZH8HcJ\/DqyY2sksE9Go1GHVqsN5fP5Yk9Pz3WIJNmctNQT8Pl8n\/DQZza40CjIokqlerywsMCTYWdnpwVjTb0kF1dXVy2sLR6Pn4HIJnu6mLZht9s3KUeUE7VarYPt459ZOqZlKMFEFRRVfI+QzMzMeBHOOTAw4GbnKt4AK6Vte0\/nHA6pBu\/T4ejoqAgnS4dTlT82U74aJOourYTn+ds1VlyNm+AReMjaK5LsdrvpxoqSyWSX8DbVSwDHtYJ+hi9gETxl\/SoCWK1WGfWJRKLQ0dGhO0kAq5MGAoFB\/OVZXC6XtqYAzvamwWCgMiDK5XKXsSL5CRpZv98vnp+fH2SNJpPpYk0BlIIXSJaB\/lOZkEqlNyCi4ahAHd8iajGUj41a2a+2xzmj0fgsFAoN0QA3lAJfAxMISDeVpx7jSbJnMplSOZ6amuptVIBaZHx8\/G0sFruj1+tlgo2KWh\/oF3opGWl+bW3t1uzsrHJ5eXm42Q+OGW\/wADc7gYe3w+Fwen19\/YByhMMgt9lsqpGRkQvYxifwfQnup9PprFwuX2rmi0ZvYAdDwurPgl1A9ek1eE7byqYR7P873+TfAgwATQiKdubVli0AAAAASUVORK5CYII=' style='cursor:pointer;float:right;height:24px;width:24px;border:0px solid transparent' alt='Clear Signature' \/ ><\/div><input type='hidden' id='input_12_96_data' name='input_12_96_data' value=''><\/div><\/div><div id=\"field_12_90\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Business Section<\/div><div id=\"field_12_1\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_1'><span class='gform-field-label__text'>Business Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_12_1' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_3\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_3'><span class='gform-field-label__text'>Business Registration Number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_12_3' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_4\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_4'><span class='gform-field-label__text'>Director<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_12_4' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_5\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_5'><span class='gform-field-label__text'>Shareholder<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_12_5' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_6\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_6'><span class='gform-field-label__text'>Employment<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_12_6' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_8\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_8'><span class='gform-field-label__text'>Trading As<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_12_8' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_33\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_33'><span class='gform-field-label__text'>Number of Employees<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_33' id='input_12_33' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_34\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_34'><span class='gform-field-label__text'>Type Of Business<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_34' id='input_12_34' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Informal Business' >Informal Business<\/option><option value='Distribution' >Distribution<\/option><option value='Wholesaler' >Wholesaler<\/option><option value='Liquor' >Liquor<\/option><option value='Fashion' >Fashion<\/option><option value='Retail Traditional' >Retail Traditional<\/option><option value='Other' >Other<\/option><\/select><\/div><\/div><div id=\"field_12_35\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_35'><span class='gform-field-label__text'>Other<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_35' id='input_12_35' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_9\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-international gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_9'><span class='gform-field-label__text'>Cell Number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_9' id='input_12_9' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"    \/><\/div><\/div><div id=\"field_12_10\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-international gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_10'><span class='gform-field-label__text'>Whatsapp Number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_10' id='input_12_10' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"    \/><\/div><\/div><div id=\"field_12_17\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><link rel=\"stylesheet\" href=\"https:\/\/unpkg.com\/leaflet@1.9.4\/dist\/leaflet.css\" \/>\n<script src=\"https:\/\/unpkg.com\/leaflet@1.9.4\/dist\/leaflet.js\"><\/script>\n\n<div id=\"gf_custom_map\" style=\"height: 350px; width: 100%; border-radius: 6px; z-index: 1;\"><\/div>\n\n<script>\ndocument.addEventListener(\"DOMContentLoaded\", function() {\n    \/\/ Default fallback coordinates (Center of South Africa)\n    var defaultLat = -28.4793; \n    var defaultLng = 24.6727; \n\n    \/\/ Zoom level set to 5 to show the whole country by default\n    var map = L.map('gf_custom_map').setView([defaultLat, defaultLng], 5);\n    \n    L.tileLayer('https:\/\/tile.openstreetmap.org\/{z}\/{x}\/{y}.png', {\n        maxZoom: 19,\n        attribution: '&copy; OpenStreetMap'\n    }).addTo(map);\n\n    var marker = L.marker([defaultLat, defaultLng], {draggable: true}).addTo(map);\n    \n    \/\/ UPDATED: Now targets Form 8, Field 18 (#input_8_18)\n    var targetInput = document.querySelector('#input_8_18'); \n\n    function writeCoords(lat, lng) {\n        if(targetInput) {\n            targetInput.value = lat.toFixed(6) + ', ' + lng.toFixed(6);\n            targetInput.dispatchEvent(new Event('change'));\n        }\n    }\n\n    writeCoords(defaultLat, defaultLng);\n\n    \/\/ Auto-Locate the user if they allow browser permissions\n    map.locate({setView: true, maxZoom: 16});\n\n    map.on('locationfound', function(e) {\n        marker.setLatLng(e.latlng);\n        writeCoords(e.latlng.lat, e.latlng.lng);\n    });\n\n    map.on('locationerror', function(e) {\n        console.log(\"Location access denied or unavailable. Using default South Africa view.\");\n    });\n\n    \/\/ Update field when pin is dragged\n    marker.on('dragend', function() {\n        var pos = marker.getLatLng();\n        writeCoords(pos.lat, pos.lng);\n    });\n\n    \/\/ Move pin to wherever user clicks on the map\n    map.on('click', function(e) {\n        marker.setLatLng(e.latlng);\n        writeCoords(e.latlng.lat, e.latlng.lng);\n    });\n});\n<\/script><\/div><div id=\"field_12_18\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gf_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><label class='gfield_label gform-field-label' for='input_12_18'><span class='gform-field-label__text'>Captured Coordinates<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_18' id='input_12_18' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_24\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_24'><span class='gform-field-label__text'>Business Address<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_24' id='input_12_24' type='text' value='' class='large'    placeholder='Business Address'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_25\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_25'><span class='gform-field-label__text'>Total Value of Stock<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_25' id='input_12_25' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Amount of Stock<\/option><option value='R0 - R10 000' >R0 - R10 000<\/option><option value='R10 000 - R50 000' >R10 000 - R50 000<\/option><option value='R50 000 - R100 000' >R50 000 - R100 000<\/option><option value='R100 000 - R500 000' >R100 000 - R500 000<\/option><option value='R500 000 - R1 000 000' >R500 000 - R1 000 000<\/option><option value='R1 000 000 - R5 000 000' >R1 000 000 - R5 000 000<\/option><\/select><\/div><\/div><fieldset id=\"field_12_26\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Compliances With Government<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_26'>\n\t\t\t<div class='gchoice gchoice_12_26_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='Yes'  id='choice_12_26_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_26_0' id='label_12_26_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_26_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='No'  id='choice_12_26_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_26_1' id='label_12_26_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_31\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Tyme Planning<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_31'>\n\t\t\t<div class='gchoice gchoice_12_31_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='Yes'  id='choice_12_31_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_31_0' id='label_12_31_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_31_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='No'  id='choice_12_31_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_31_1' id='label_12_31_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_30\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>AMS<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_30'>\n\t\t\t<div class='gchoice gchoice_12_30_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='Yes'  id='choice_12_30_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_30_0' id='label_12_30_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_30_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='No'  id='choice_12_30_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_30_1' id='label_12_30_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_29\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Economic Development<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_29'>\n\t\t\t<div class='gchoice gchoice_12_29_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='Yes'  id='choice_12_29_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_29_0' id='label_12_29_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_29_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='No'  id='choice_12_29_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_29_1' id='label_12_29_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_28\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Small Business Development<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_28'>\n\t\t\t<div class='gchoice gchoice_12_28_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='Yes'  id='choice_12_28_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_28_0' id='label_12_28_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_28_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='No'  id='choice_12_28_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_28_1' id='label_12_28_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_37\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Section 22 Permit<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_37'>\n\t\t\t<div class='gchoice gchoice_12_37_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='Yes'  id='choice_12_37_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_37_0' id='label_12_37_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_37_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='No'  id='choice_12_37_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_37_1' id='label_12_37_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_41\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Zoning Permit<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_41'>\n\t\t\t<div class='gchoice gchoice_12_41_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_41' type='radio' value='Yes'  id='choice_12_41_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_41_0' id='label_12_41_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_41_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_41' type='radio' value='No'  id='choice_12_41_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_41_1' id='label_12_41_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_40\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>EMS (Fire Certificate)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_40'>\n\t\t\t<div class='gchoice gchoice_12_40_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='Yes'  id='choice_12_40_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_40_0' id='label_12_40_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_40_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='No'  id='choice_12_40_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_40_1' id='label_12_40_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_39\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Building Plans<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_39'>\n\t\t\t<div class='gchoice gchoice_12_39_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='Yes'  id='choice_12_39_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_39_0' id='label_12_39_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_39_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='No'  id='choice_12_39_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_39_1' id='label_12_39_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_38\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Health Certificate<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_38'>\n\t\t\t<div class='gchoice gchoice_12_38_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='Yes'  id='choice_12_38_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_38_0' id='label_12_38_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_38_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='No'  id='choice_12_38_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_38_1' id='label_12_38_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_46\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Company Registration<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_46'>\n\t\t\t<div class='gchoice gchoice_12_46_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='Yes'  id='choice_12_46_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_46_0' id='label_12_46_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_46_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='No'  id='choice_12_46_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_46_1' id='label_12_46_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_45\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Tax No<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_45'>\n\t\t\t<div class='gchoice gchoice_12_45_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_45' type='radio' value='Yes'  id='choice_12_45_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_45_0' id='label_12_45_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_45_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_45' type='radio' value='No'  id='choice_12_45_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_45_1' id='label_12_45_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_44\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Business Permit From Municipality<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_44'>\n\t\t\t<div class='gchoice gchoice_12_44_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='Yes'  id='choice_12_44_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_44_0' id='label_12_44_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_44_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='No'  id='choice_12_44_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_44_1' id='label_12_44_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_43\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Certificate Of Acceptability<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_43'>\n\t\t\t<div class='gchoice gchoice_12_43_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='Yes'  id='choice_12_43_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_43_0' id='label_12_43_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_43_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='No'  id='choice_12_43_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_43_1' id='label_12_43_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_12_11\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_11'><span class='gform-field-label__text'>Company Documentation<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='1073741824' \/><input name='input_11' id='input_12_11' type='file' class='large' aria-describedby=\"gfield_upload_rules_12_11\" onchange='javascript:gformValidateFileSize( this, 1073741824 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_12_11'>Max. file size: 1 GB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_12_11'><\/div> <\/div><\/div><div id=\"field_12_32\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_32'><span class='gform-field-label__text'>ID Documentation<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='1073741824' \/><input name='input_32' id='input_12_32' type='file' class='large' aria-describedby=\"gfield_upload_rules_12_32\" onchange='javascript:gformValidateFileSize( this, 1073741824 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_12_32'>Max. file size: 1 GB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_12_32'><\/div> <\/div><\/div><div id=\"field_12_20\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_20'><span class='gform-field-label__text'>Picture of Shop<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='1073741824' \/><input name='input_20' id='input_12_20' type='file' class='large' aria-describedby=\"gfield_upload_rules_12_20\" onchange='javascript:gformValidateFileSize( this, 1073741824 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_12_20'>Max. file size: 1 GB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_12_20'><\/div> <\/div><\/div><div id=\"field_12_19\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_19'><span class='gform-field-label__text'>Video Of Shop<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='1073741824' \/><input name='input_19' id='input_12_19' type='file' class='large' aria-describedby=\"gfield_upload_rules_12_19\" onchange='javascript:gformValidateFileSize( this, 1073741824 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_12_19'>Max. file size: 1 GB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_12_19'><\/div> <\/div><\/div><div id=\"field_12_21\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_21'><span class='gform-field-label__text'>Picture Of Stock<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='1073741824' \/><input name='input_21' id='input_12_21' type='file' class='large' aria-describedby=\"gfield_upload_rules_12_21\" onchange='javascript:gformValidateFileSize( this, 1073741824 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_12_21'>Max. file size: 1 GB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_12_21'><\/div> <\/div><\/div><div id=\"field_12_36\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_36'><span class='gform-field-label__text'>Video of Stock (No Interuptions)<\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='1073741824' \/><input name='input_36' id='input_12_36' type='file' class='large' aria-describedby=\"gfield_upload_rules_12_36\" onchange='javascript:gformValidateFileSize( this, 1073741824 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_12_36'>Max. file size: 1 GB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_12_36'><\/div> <\/div><\/div><fieldset id=\"field_12_97\" class=\"gfield gfield--type-multi_choice gfield--type-choice gfield--input-type-checkbox gf_list_2col gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-columns\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Interested Services<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_12_97'><div class='gchoice gchoice_12_97_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.4' type='checkbox'  value='Company registration'  id='choice_12_97_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_1' id='label_12_97_1' class='gform-field-label gform-field-label--type-inline'>Company registration<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.5' type='checkbox'  value='Business cover of up to R700,000'  id='choice_12_97_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_2' id='label_12_97_2' class='gform-field-label gform-field-label--type-inline'>Business cover of up to R700,000<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.6' type='checkbox'  value='Assistance with opening business bank accounts'  id='choice_12_97_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_3' id='label_12_97_3' class='gform-field-label gform-field-label--type-inline'>Assistance with opening business bank accounts<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.7' type='checkbox'  value='Business Funding'  id='choice_12_97_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_4' id='label_12_97_4' class='gform-field-label gform-field-label--type-inline'>Business Funding<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.8' type='checkbox'  value='Micro loans'  id='choice_12_97_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_5' id='label_12_97_5' class='gform-field-label gform-field-label--type-inline'>Micro loans<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.9' type='checkbox'  value='Asset finance'  id='choice_12_97_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_6' id='label_12_97_6' class='gform-field-label gform-field-label--type-inline'>Asset finance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.11' type='checkbox'  value='Certificate of Acceptability'  id='choice_12_97_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_7' id='label_12_97_7' class='gform-field-label gform-field-label--type-inline'>Certificate of Acceptability<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.12' type='checkbox'  value='Town planning'  id='choice_12_97_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_8' id='label_12_97_8' class='gform-field-label gform-field-label--type-inline'>Town planning<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.13' type='checkbox'  value='Zoning certificate'  id='choice_12_97_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_9' id='label_12_97_9' class='gform-field-label gform-field-label--type-inline'>Zoning certificate<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.14' type='checkbox'  value='Permit from the Department of Economic Development'  id='choice_12_97_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_11' id='label_12_97_11' class='gform-field-label gform-field-label--type-inline'>Permit from the Department of Economic Development<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.15' type='checkbox'  value='Fire and Safety Certificate'  id='choice_12_97_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_12' id='label_12_97_12' class='gform-field-label gform-field-label--type-inline'>Fire and Safety Certificate<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.16' type='checkbox'  value='Tax number (Tax No.) setup'  id='choice_12_97_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_13' id='label_12_97_13' class='gform-field-label gform-field-label--type-inline'>Tax number (Tax No.) setup<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.17' type='checkbox'  value='Labour law compliance'  id='choice_12_97_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_14' id='label_12_97_14' class='gform-field-label gform-field-label--type-inline'>Labour law compliance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.18' type='checkbox'  value='South African ID applications for Ethiopian children born in South Africa'  id='choice_12_97_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_15' id='label_12_97_15' class='gform-field-label gform-field-label--type-inline'>South African ID applications for Ethiopian children born in South Africa<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.19' type='checkbox'  value='University funding for children who pass Matric'  id='choice_12_97_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_16' id='label_12_97_16' class='gform-field-label gform-field-label--type-inline'>University funding for children who pass Matric<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_17'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.21' type='checkbox'  value='R120 000 Funeral cover'  id='choice_12_97_17'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_17' id='label_12_97_17' class='gform-field-label gform-field-label--type-inline'>R120 000 Funeral cover<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_18'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.22' type='checkbox'  value='Renewal and extension of Section 22 (Asylum Seeker Permit) and Section 24 (Refugee Status Permit)'  id='choice_12_97_18'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_18' id='label_12_97_18' class='gform-field-label gform-field-label--type-inline'>Renewal and extension of Section 22 (Asylum Seeker Permit) and Section 24 (Refugee Status Permit)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_19'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.23' type='checkbox'  value='Assistance with obtaining an Asylum Seeker Permit for newcomers'  id='choice_12_97_19'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_19' id='label_12_97_19' class='gform-field-label gform-field-label--type-inline'>Assistance with obtaining an Asylum Seeker Permit for newcomers<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_21'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.24' type='checkbox'  value='Resettlement country'  id='choice_12_97_21'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_21' id='label_12_97_21' class='gform-field-label gform-field-label--type-inline'>Resettlement country<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_22'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.25' type='checkbox'  value='Translation services'  id='choice_12_97_22'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_22' id='label_12_97_22' class='gform-field-label gform-field-label--type-inline'>Translation services<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_23'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.26' type='checkbox'  value='Assistance with opening personal bank accounts'  id='choice_12_97_23'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_23' id='label_12_97_23' class='gform-field-label gform-field-label--type-inline'>Assistance with opening personal bank accounts<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_24'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.27' type='checkbox'  value='Legal services'  id='choice_12_97_24'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_24' id='label_12_97_24' class='gform-field-label gform-field-label--type-inline'>Legal services<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_25'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.28' type='checkbox'  value='R1 million life insurance through Absa'  id='choice_12_97_25'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_25' id='label_12_97_25' class='gform-field-label gform-field-label--type-inline'>R1 million life insurance through Absa<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_26'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.29' type='checkbox'  value='Hospital cover'  id='choice_12_97_26'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_26' id='label_12_97_26' class='gform-field-label gform-field-label--type-inline'>Hospital cover<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_27'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.31' type='checkbox'  value='Cover for flood damage'  id='choice_12_97_27'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_27' id='label_12_97_27' class='gform-field-label gform-field-label--type-inline'>Cover for flood damage<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_28'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.32' type='checkbox'  value='Cover for fire damage'  id='choice_12_97_28'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_28' id='label_12_97_28' class='gform-field-label gform-field-label--type-inline'>Cover for fire damage<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_97_29'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.33' type='checkbox'  value='Cover for theft'  id='choice_12_97_29'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_97_29' id='label_12_97_29' class='gform-field-label gform-field-label--type-inline'>Cover for theft<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_15\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Consent<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_15.1' id='input_12_15_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_12_15_1' ><span class='gform-field-label__text'>I agree to the privacy policy.<\/span><\/label><input type='hidden' name='input_15.2' value='I agree to the privacy policy.' class='gform_hidden' \/><input type='hidden' name='input_15.3' value='7' class='gform_hidden' \/><\/div><\/fieldset><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <button type='submit' id='gform_submit_button_12' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Submit<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_12' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_12' id='gform_theme_12' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_12' id='gform_style_settings_12' value='' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_12' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='12' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='ZAR' value='nLqCGWUge5k1oE6DNOPrLknu6aOt+EuimdPK4aGQMknDgyN97R3esEo8qWCt8rP2lZ2UCyIRNUqa7+MCHrAVk8i+w9JVrwnkMghE0WuyT7Ykmh4=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_12' 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