{"id":4014,"date":"2022-10-06T16:31:20","date_gmt":"2022-10-06T21:31:20","guid":{"rendered":"https:\/\/www.zvhc.org\/?page_id=4014"},"modified":"2022-10-06T16:32:09","modified_gmt":"2022-10-06T21:32:09","slug":"internship-application","status":"publish","type":"page","link":"https:\/\/www.zvhc.org\/careers\/internship-application\/","title":{"rendered":"Internship Application"},"content":{"rendered":"\n<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_safari gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_39' style='display:none'>\n                        <div class='gform_heading'>\n                            <h3 class=\"gform_title\">Internship Application<\/h3>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_39'  action='\/wp-json\/wp\/v2\/pages\/4014' data-formid='39' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_39' class='gform_fields top_label form_sublabel_below description_below'><li id=\"field_39_34\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_39_34\" ><h2 class=\"gsection_title\">Applicant Information<\/h2><\/li><li id=\"field_39_78\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_39_78\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Field of Study<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_39_78'>Zumbro Valley Health Center accepts interns for the following degrees. Please check all that apply:<\/div><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_39_78'><li class='gchoice gchoice_39_78_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.1' type='checkbox'  value='Dual license as an LPCC and LADC'  id='choice_39_78_1'   aria-describedby=\"gfield_description_39_78\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_39_78_1' id='label_39_78_1' class='gform-field-label gform-field-label--type-inline'>Dual license as an LPCC and LADC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_39_78_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.2' type='checkbox'  value='Bachelor&#039;s in Social Work'  id='choice_39_78_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_39_78_2' id='label_39_78_2' class='gform-field-label gform-field-label--type-inline'>Bachelor's in Social Work<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_39_78_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.3' type='checkbox'  value='Bachelor&#039;s Degree in pursuit of a license in Alcohol &amp; Drug Counseling'  id='choice_39_78_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_39_78_3' id='label_39_78_3' class='gform-field-label gform-field-label--type-inline'>Bachelor's Degree in pursuit of a license in Alcohol &amp; Drug Counseling<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_39_78_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.4' type='checkbox'  value='Master&#039;s in Social Work'  id='choice_39_78_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_39_78_4' id='label_39_78_4' class='gform-field-label gform-field-label--type-inline'>Master's in Social Work<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_39_78_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.5' type='checkbox'  value='Master&#039;s in Counseling'  id='choice_39_78_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_39_78_5' id='label_39_78_5' class='gform-field-label gform-field-label--type-inline'>Master's in Counseling<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_39_78_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.6' type='checkbox'  value='Other'  id='choice_39_78_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_39_78_6' id='label_39_78_6' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_39_92\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_39_92\" ><label class='gfield_label gform-field-label' for='input_39_92'>Please Specify Other Field of Study<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_92' id='input_39_92' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_39_93\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_39_93\" ><label class='gfield_label gform-field-label' >Are you currently an employee at Zumbro Valley Health Center?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_39_93'>\n\t\t\t<li class='gchoice gchoice_39_93_0'>\n\t\t\t\t<input name='input_93' type='radio' value='Yes'  id='choice_39_93_0'    \/>\n\t\t\t\t<label for='choice_39_93_0' id='label_39_93_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_39_93_1'>\n\t\t\t\t<input name='input_93' type='radio' value='No'  id='choice_39_93_1'    \/>\n\t\t\t\t<label for='choice_39_93_1' id='label_39_93_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_39_2\" class=\"gfield gfield--type-date gfield--input-type-datedropdown gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_39_2\" ><label class='gfield_label gform-field-label' >Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div id='input_39_2' class='ginput_container ginput_complex gform-grid-row'><div class=\"clear-multi\"><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_39_2_1_container'><select name='input_2[]' id='input_39_2_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_39_2_2_container'><select name='input_2[]' id='input_39_2_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_39_2_3_container'><select name='input_2[]' id='input_39_2_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/div><\/li><li id=\"field_39_87\" class=\"gfield gfield--type-text hipaa_forms_first_name gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_39_87\" ><label class='gfield_label gform-field-label' for='input_39_87'>First Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_87' id='input_39_87' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_39_88\" class=\"gfield gfield--type-text hipaa_forms_last_name gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_39_88\" ><label class='gfield_label gform-field-label' for='input_39_88'>Last Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_88' id='input_39_88' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_39_3\" class=\"gfield gfield--type-address gfield_contains_required field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_39_3\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_39_3' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_39_3_1_container' >\n                                        <input type='text' name='input_3.1' id='input_39_3_1' value=''    aria-required='true'    \/>\n                                        <label for='input_39_3_1' id='input_39_3_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_39_3_2_container' >\n                                        <input type='text' name='input_3.2' id='input_39_3_2' value=''     aria-required='false'   \/>\n                                        <label for='input_39_3_2' id='input_39_3_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_39_3_3_container' >\n                                    <input type='text' name='input_3.3' id='input_39_3_3' value=''    aria-required='true'    \/>\n                                    <label for='input_39_3_3' id='input_39_3_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_39_3_4_container' >\n                                        <select name='input_3.4' id='input_39_3_4'     aria-required='true'    ><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_39_3_4' id='input_39_3_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_39_3_5_container' >\n                                    <input type='text' name='input_3.5' id='input_39_3_5' value=''    aria-required='true'    \/>\n                                    <label for='input_39_3_5' id='input_39_3_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_3.6' id='input_39_3_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_39_4\" class=\"gfield gfield--type-phone hipaa_forms_phone gfield_contains_required field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_39_4\" ><label class='gfield_label gform-field-label' for='input_39_4'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_4' id='input_39_4' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_39_5\" class=\"gfield gfield--type-email hipaa_forms_email gfield_contains_required field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_39_5\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_39_5_container'>\n                                <span id='input_39_5_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_5' id='input_39_5' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_39_5' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_39_5_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_5_2' id='input_39_5_2' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_39_5_2' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/li><li id=\"field_39_41\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_39_41\" ><h2 class=\"gsection_title\">School Information<\/h2><\/li><li id=\"field_39_21\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_39_21\" ><label class='gfield_label gform-field-label' for='input_39_21'>School Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_21' id='input_39_21' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_39_42\" class=\"gfield gfield--type-address gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_39_42\" ><label class='gfield_label gform-field-label screen-reader-text gfield_label_before_complex' ><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address gform-grid-row' id='input_39_42' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_39_42_1_container' >\n                                        <label for='input_39_42_1' id='input_39_42_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_42.1' id='input_39_42_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_39_42_3_container' >\n                                    <label for='input_39_42_3' id='input_39_42_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_42.3' id='input_39_42_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_39_42_4_container' >\n                                        <label for='input_39_42_4' id='input_39_42_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                        <select name='input_42.4' id='input_39_42_4'     aria-required='true'    ><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_39_42_5_container' >\n                                    <label for='input_39_42_5' id='input_39_42_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                    <input type='text' name='input_42.5' id='input_39_42_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_42.6' id='input_39_42_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_39_43\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_39_43\" ><label class='gfield_label gform-field-label' for='input_39_43'>Major<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_43' id='input_39_43' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_39_44\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_39_44\" ><label class='gfield_label gform-field-label' for='input_39_44'>Minor<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_44' id='input_39_44' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_39_45\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_39_45\" ><label class='gfield_label gform-field-label' for='input_39_45'>Year in School<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_45' id='input_39_45' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_39_46\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_39_46\" ><label class='gfield_label gform-field-label' for='input_39_46'>Current GPA or Pass\/Fail Status<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_46' id='input_39_46' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_39_82\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_39_82\" ><label class='gfield_label gform-field-label' for='input_39_82'>Expected Date of Graduation<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_82' id='input_39_82' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_39_50\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_39_50\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Advisor Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_39_50'>\n                            \n                            <span id='input_39_50_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_39_50_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_50.3' id='input_39_50_3' value=''   aria-required='true'     \/>\n                                                <\/span>\n                            \n                            <span id='input_39_50_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_39_50_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_50.6' id='input_39_50_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/li><li id=\"field_39_89\" class=\"gfield gfield--type-fileupload gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_39_89\" ><label class='gfield_label gform-field-label' for='input_39_89'>Attach your program objectives or requirements that are required for completion of internship<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='536870912' \/><input name='input_89' id='input_39_89' type='file' class='medium' aria-describedby=\"gfield_upload_rules_39_89\" onchange='javascript:gformValidateFileSize( this, 536870912 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_39_89'>Max. file size: 512 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_39_89'><\/div><\/div><\/li><li id=\"field_39_53\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_39_53\" ><h2 class=\"gsection_title\">Other<\/h2><\/li><li id=\"field_39_90\" class=\"gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_39_90\" ><label class='gfield_label gform-field-label' for='input_39_90'>Is there a specific population of interest you would like to work with?<\/label><div class='ginput_container ginput_container_select'><select name='input_90' id='input_39_90' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select a population<\/option><option value='LGBTQ+' >LGBTQ+<\/option><option value='Primarily Substance Use Disorder' >Primarily Substance Use Disorder<\/option><option value='Families' >Families<\/option><option value='Children 0-5' >Children 0-5<\/option><option value='Children 5-12' >Children 5-12<\/option><option value='Adolescents' >Adolescents<\/option><option value='Elderly' >Elderly<\/option><option value='Couples' >Couples<\/option><option value='Co-occurring Substance Use Disorder and Mental Health' >Co-occurring Substance Use Disorder and Mental Health<\/option><option value='Mental Health' >Mental Health<\/option><\/select><\/div><\/li><li id=\"field_39_54\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_39_54\" ><label class='gfield_label gform-field-label' >Do you speak and understand any foreign languages?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_39_54'>\n\t\t\t<li class='gchoice gchoice_39_54_0'>\n\t\t\t\t<input name='input_54' type='radio' value='Yes'  id='choice_39_54_0'    \/>\n\t\t\t\t<label for='choice_39_54_0' id='label_39_54_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_39_54_1'>\n\t\t\t\t<input name='input_54' type='radio' value='No'  id='choice_39_54_1'    \/>\n\t\t\t\t<label for='choice_39_54_1' id='label_39_54_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_39_84\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_39_84\" ><label class='gfield_label gform-field-label' for='input_39_84'>Please list all languages spoken fluently:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_84' id='input_39_84' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_39_83\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_39_83\" ><label class='gfield_label gform-field-label' for='input_39_83'>Please list the duration of when you are looking to complete internship with start and end dates<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_83' id='input_39_83' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_39_91\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_39_91\" ><label class='gfield_label gform-field-label' for='input_39_91'>What is the total number of hours your internship requires?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_91' id='input_39_91' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_39_56\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_39_56\" ><label class='gfield_label gform-field-label' for='input_39_56'>What are the days and times you are available?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_56' id='input_39_56' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_39_57\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_39_57\" ><label class='gfield_label gform-field-label' >Do you have a driver&#039;s license and use of car?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_39_57'>\n\t\t\t<li class='gchoice gchoice_39_57_0'>\n\t\t\t\t<input name='input_57' type='radio' value='Yes'  id='choice_39_57_0'    \/>\n\t\t\t\t<label for='choice_39_57_0' id='label_39_57_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_39_57_1'>\n\t\t\t\t<input name='input_57' type='radio' value='No'  id='choice_39_57_1'    \/>\n\t\t\t\t<label for='choice_39_57_1' id='label_39_57_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_39_57_2'>\n\t\t\t\t<input name='input_57' type='radio' value='License Only'  id='choice_39_57_2'    \/>\n\t\t\t\t<label for='choice_39_57_2' id='label_39_57_2' class='gform-field-label gform-field-label--type-inline'>License Only<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_39_36\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_39_36\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >How did you hear about Zumbro Valley Health Center?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_39_36'><li class='gchoice gchoice_39_36_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.1' type='checkbox'  value='Social Media'  id='choice_39_36_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_39_36_1' id='label_39_36_1' class='gform-field-label gform-field-label--type-inline'>Social Media<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_39_36_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.2' type='checkbox'  value='Internet Search'  id='choice_39_36_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_39_36_2' id='label_39_36_2' class='gform-field-label gform-field-label--type-inline'>Internet Search<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_39_36_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.3' type='checkbox'  value='Print Ad (newspaper, magazine, mailer)'  id='choice_39_36_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_39_36_3' id='label_39_36_3' class='gform-field-label gform-field-label--type-inline'>Print Ad (newspaper, magazine, mailer)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_39_36_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.4' type='checkbox'  value='Radio'  id='choice_39_36_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_39_36_4' id='label_39_36_4' class='gform-field-label gform-field-label--type-inline'>Radio<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_39_36_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.5' type='checkbox'  value='TV'  id='choice_39_36_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_39_36_5' id='label_39_36_5' class='gform-field-label gform-field-label--type-inline'>TV<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_39_36_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.6' type='checkbox'  value='Referral'  id='choice_39_36_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_39_36_6' id='label_39_36_6' class='gform-field-label gform-field-label--type-inline'>Referral<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_39_36_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.7' type='checkbox'  value='Other'  id='choice_39_36_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_39_36_7' id='label_39_36_7' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_39_79\" class=\"gfield gfield--type-fileupload gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_39_79\" ><label class='gfield_label gform-field-label' for='gform_browse_button_39_79'>Cover Letter (pdf)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_39_79' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_39_79&quot;,&quot;container&quot;:&quot;gform_multifile_upload_39_79&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_39_79&quot;,&quot;filelist&quot;:&quot;gform_preview_39_79&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/www.zvhc.org\\\/?gf_page=3d85ae38c00a5b4&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/www.zvhc.org\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/www.zvhc.org\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;pdf&quot;}],&quot;max_file_size&quot;:&quot;536870912b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:39,&quot;field_id&quot;:79},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_39_79&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_39_79' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_39_79' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_39_79\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_39_79'>Accepted file types: pdf, Max. file size: 512 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_39_79'><\/ul> <!-- Leave <ul> empty to support CSS :empty selector. --><\/div><div id='gform_preview_39_79' class='ginput_preview_list'><\/div><\/li><li id=\"field_39_80\" class=\"gfield gfield--type-fileupload gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_39_80\" ><label class='gfield_label gform-field-label' for='input_39_80'>Resume<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='536870912' \/><input name='input_80' id='input_39_80' type='file' class='medium' aria-describedby=\"gfield_upload_rules_39_80\" onchange='javascript:gformValidateFileSize( this, 536870912 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_39_80'>Max. file size: 512 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_39_80'><\/div><\/div><\/li><li id=\"field_39_81\" class=\"gfield gfield--type-fileupload gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_39_81\" ><label class='gfield_label gform-field-label' for='input_39_81'>References<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='536870912' \/><input name='input_81' id='input_39_81' type='file' class='medium' aria-describedby=\"gfield_upload_rules_39_81\" onchange='javascript:gformValidateFileSize( this, 536870912 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_39_81'>Max. file size: 512 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_39_81'><\/div><\/div><\/li><li id=\"field_39_86\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_39_86\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >HIPAA Privacy Policy<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_consent'><input name='input_86.1' id='input_39_86_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_39_86\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_39_86_1' >I have read and agree to the HIPAA Privacy Statement.<\/label><input type='hidden' name='input_86.2' value='I have read and agree to the HIPAA Privacy Statement.' class='gform_hidden' \/><input type='hidden' name='input_86.3' value='46' class='gform_hidden' \/><\/div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_39_86'>Notice of Information\/Privacy Practices<br \/>\n<br \/>\nThis \"Notice of Information\/Privacy Practices\" is used to inform website visitors regarding our policies with the collection, use, and disclosure of Personal Information if anyone decided to use our Service.<br \/>\n<br \/>\nIf you choose to use our Service, then you agree to the collection and use of information with anyone except as described in this Privacy Policy.<br \/>\n<br \/>\nInformation Collection and Use<br \/>\nFor a better experience while using our Service, we may require you to provide us with certain personality identifiable information, including but not limited to your name, phone number, and postal address. The information we collect will be used to contact or identify you.<br \/>\n<br \/>\nLog Data<br \/>\nWe want to inform you that whenever you visit our Service, we collect information that your browser sends to us that is called Log Data. This Log Data may include information such as your computer's internet Protocol (\"IP\") address, browser version, pages of our Service that you visit, the time and date of your visit, the time spent on those pages, and other statistics.<br \/>\n<br \/>\nCookies<br \/>\nCookies are files with small amount of data that is commonly used as an anonymous unique identifier. These are sent to your browser from the website that you visit and are stored on your computer's hard drive.<br \/>\n<br \/>\nOur website uses these \"cookies\" to collect information and to improve our Service. you have the option to either accept or refuse these cookies, and know when a cookie is being sent to your computer. If you choose to refuse our cookies, you may not be able to use some portions of our Service.<br \/>\n<br \/>\nService Providers<br \/>\nWe may employ third-party companies and individuals due to the following reasons:<br \/>\nTo facilitate our Service; <br \/>\nTo provide the Service on our behalf;<br \/>\nTo assist us in analyzing how our Service is used.<br \/>\n<br \/>\nWe want to inform our Service users that these third parties have access to your Personal Information. The reason is to perform the tasks assigned to them on our behalf. However, they are obligated not to discuss or use the information for any other purpose.<br \/>\n<br \/>\nSecurity<br \/>\nWe value your trust in providing us your Personal Information, thus we are striving to use commercially acceptable means of protecting it. But remember that no method of transmission over the internet, or method of electronic storage is 100% secure and reliable, and we cannot guarantee its absolute security.<br \/>\n<br \/>\nLinks to Other Sites<br \/>\nOur Service may contain links to other sites. If you click on a third-party link, you will be directed to that site. Note that these external sites are not operated by us. Therefore, we strongly advise you to review the Privacy Policy of these websites. We have no control over, and assume no responsibility for the content, privacy policies, or practices of any third-party sites or services.<br \/>\n<br \/>\nChanges to This Privacy Policy<br \/>\nWe may update our Privacy Policy from time to time. Thus, we advise you to review this page periodically for any changes. We will notify you of any changes by posting the new Privacy Policy on this page. 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