{"id":47452,"date":"2025-08-21T12:58:21","date_gmt":"2025-08-21T16:58:21","guid":{"rendered":"https:\/\/nche.com\/?page_id=47452"},"modified":"2026-01-12T11:47:29","modified_gmt":"2026-01-12T16:47:29","slug":"diploma-order-from-nonmember","status":"publish","type":"page","link":"https:\/\/nche.com\/vi\/diploma-order-from-nonmember\/","title":{"rendered":"\u0110\u1eb7t mua b\u1eb1ng t\u1ed1t nghi\u1ec7p t\u1eeb (ng\u01b0\u1eddi kh\u00f4ng ph\u1ea3i th\u00e0nh vi\u00ean)"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.27.3&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row column_structure=&#8221;2_3,1_3&#8243; _builder_version=&#8221;4.27.3&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;2_3&#8243; _builder_version=&#8221;4.27.3&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.27.3&#8243; _module_preset=&#8221;default&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;]<\/p>\n<script data-jetpack-boost=\"ignore\">\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_300' style='display:none'>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Diploma Order Form (Nonmember)<\/h2>\n                            <p class='gform_description'><\/p>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_300'  action='\/vi\/wp-json\/wp\/v2\/pages\/47452' data-formid='300' novalidate>\t\t\t\t\t<div style=\"display: none !important;\" class=\"akismet-fields-container gf_invisible\" data-prefix=\"ak_\">\n\t\t\t\t\t\t<label>&#916;<textarea name=\"ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label>\n\t\t\t\t\t\t<input type=\"hidden\" id=\"ak_js_1\" name=\"ak_js\" value=\"107\" \/>\n\t\t\t\t\t\t<script data-jetpack-boost=\"ignore\">\ndocument.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );\n<\/script>\n\n\t\t\t\t\t<\/div>\n                        <div class='gform-body gform_body'><div id='gform_fields_300' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_300_44\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Contact Information<\/h3><\/div><div id=\"field_300_36\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_36' id='input_300_36' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><fieldset id=\"field_300_42\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Is this your first time registering for an event or activity or your first transaction with NCHE?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_300_42'>Please select yes or no.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_300_42'>\n\t\t\t<div class='gchoice gchoice_300_42_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='Yes'  id='choice_300_42_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_300_42\"   \/>\n\t\t\t\t\t<label for='choice_300_42_0' id='label_300_42_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_300_42_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='No'  id='choice_300_42_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_300_42_1' id='label_300_42_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_300_3\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Primary Contact Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_300_3'><p><span style=\"display: inline !important; float: none; background-color: transparent; color: rgb(51, 51, 51); font-family: &quot;Droid Sans&quot;,arial,sans-serif; font-size: 12.26px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;\">Parent, legal guardian or member of the household<\/span><\/p>\n<\/div><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_300_3'>\n                            \n                            <span id='input_300_3_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_300_3_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_3.3' id='input_300_3_3' value=''   aria-required='true'     \/>\n                                                <\/span>\n                            \n                            <span id='input_300_3_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_300_3_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_3.6' id='input_300_3_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_300_30\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \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_300_30' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_300_30_1_container' >\n                                        <label for='input_300_30_1' id='input_300_30_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_30.1' id='input_300_30_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_300_30_2_container' >\n                                        <label for='input_300_30_2' id='input_300_30_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                        <input type='text' name='input_30.2' id='input_300_30_2' value=''     aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_300_30_3_container' >\n                                    <label for='input_300_30_3' id='input_300_30_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_30.3' id='input_300_30_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_300_30_4_container' >\n                                        <label for='input_300_30_4' id='input_300_30_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                        <select name='input_30.4' id='input_300_30_4'     aria-required='true'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >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' selected='selected'>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_300_30_5_container' >\n                                    <label for='input_300_30_5' id='input_300_30_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                    <input type='text' name='input_30.5' id='input_300_30_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_30.6' id='input_300_30_6' value='US' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_300_24\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_24'><span class='gform-field-label__text'>North Carolina County in which the homeschool is located<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_24' id='input_300_24' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='Alamance County' >Alamance County<\/option><option value='Alexander County' >Alexander County<\/option><option value='Alleghany County' >Alleghany County<\/option><option value='Anson County' >Anson County<\/option><option value='Ashe County' >Ashe County<\/option><option value='Avery County' >Avery County<\/option><option value='Beaufort County' >Beaufort County<\/option><option value='Bertie County' >Bertie County<\/option><option value='Bladen County' >Bladen County<\/option><option value='Brunswick County' >Brunswick County<\/option><option value='Buncombe County' >Buncombe County<\/option><option value='Burke County' >Burke County<\/option><option value='Cabarrus County' >Cabarrus County<\/option><option value='Caldwell County' >Caldwell County<\/option><option value='Camden County' >Camden County<\/option><option value='Carteret County' >Carteret County<\/option><option value='Caswell County' >Caswell County<\/option><option value='Catawba County' >Catawba County<\/option><option value='Chatham County' >Chatham County<\/option><option value='Cherokee County' >Cherokee County<\/option><option value='Chowan County' >Chowan County<\/option><option value='Clay County' >Clay County<\/option><option value='Cleveland County' >Cleveland County<\/option><option value='Columbus County' >Columbus County<\/option><option value='Craven County' >Craven County<\/option><option value='Cumberland County' >Cumberland County<\/option><option value='Currituck County' >Currituck County<\/option><option value='Dare County' >Dare County<\/option><option value='Davidson County' >Davidson County<\/option><option value='Davie County' >Davie County<\/option><option value='Duplin County' >Duplin County<\/option><option value='Durham County' >Durham County<\/option><option value='Edgecombe County' >Edgecombe County<\/option><option value='Forsyth County' >Forsyth County<\/option><option value='Franklin County' >Franklin County<\/option><option value='Gaston County' >Gaston County<\/option><option value='Gates County' >Gates County<\/option><option value='Graham County' >Graham County<\/option><option value='Granville County' >Granville County<\/option><option value='Greene County' >Greene County<\/option><option value='Guilford County' >Guilford County<\/option><option value='Halifax County' >Halifax County<\/option><option value='Harnett County' >Harnett County<\/option><option value='Haywood County' >Haywood County<\/option><option value='Henderson County' >Henderson County<\/option><option value='Hertford County' >Hertford County<\/option><option value='Hoke County' >Hoke County<\/option><option value='Hyde County' >Hyde County<\/option><option value='Iredell County' >Iredell County<\/option><option value='Jackson County' >Jackson County<\/option><option value='Johnston County' >Johnston County<\/option><option value='Jones County' >Jones County<\/option><option value='Lee County' >Lee County<\/option><option value='Lenoir County' >Lenoir County<\/option><option value='Lincoln County' >Lincoln County<\/option><option value='McDowell County' >McDowell County<\/option><option value='Macon County' >Macon County<\/option><option value='Madison County' >Madison County<\/option><option value='Martin County' >Martin County<\/option><option value='Mecklenburg County' >Mecklenburg County<\/option><option value='Mitchell County' >Mitchell County<\/option><option value='Montgomery County' >Montgomery County<\/option><option value='Moore County' >Moore County<\/option><option value='Nash County' >Nash County<\/option><option value='New Hanover County' >New Hanover County<\/option><option value='Northampton County' >Northampton County<\/option><option value='Onslow County' >Onslow County<\/option><option value='Orange County' >Orange County<\/option><option value='Pamlico County' >Pamlico County<\/option><option value='Pasquotank County' >Pasquotank County<\/option><option value='Pender County' >Pender County<\/option><option value='Perquimans County' >Perquimans County<\/option><option value='Person County' >Person County<\/option><option value='Pitt County' >Pitt County<\/option><option value='Polk County' >Polk County<\/option><option value='Randolph County' >Randolph County<\/option><option value='Richmond County' >Richmond County<\/option><option value='Robeson County' >Robeson County<\/option><option value='Rockingham County' >Rockingham County<\/option><option value='Rowan County' >Rowan County<\/option><option value='Rutherford County' >Rutherford County<\/option><option value='Sampson County' >Sampson County<\/option><option value='Scotland County' >Scotland County<\/option><option value='Stanly County' >Stanly County<\/option><option value='Stokes County' >Stokes County<\/option><option value='Surry County' >Surry County<\/option><option value='Swain County' >Swain County<\/option><option value='Transylvania County' >Transylvania County<\/option><option value='Tyrrell County' >Tyrrell County<\/option><option value='Union County' >Union County<\/option><option value='Vance County' >Vance County<\/option><option value='Wake County' >Wake County<\/option><option value='Warren County' >Warren County<\/option><option value='Washington County' >Washington County<\/option><option value='Watauga County' >Watauga County<\/option><option value='Wayne County' >Wayne County<\/option><option value='Wilkes County' >Wilkes County<\/option><option value='Wilson County' >Wilson County<\/option><option value='Yadkin County' >Yadkin County<\/option><option value='Yancey County' >Yancey County<\/option><\/select><\/div><\/div><div id=\"field_300_5\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_5'><span class='gform-field-label__text'>Primary Contact Email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_300_5'><p><span style=\"display: inline !important; float: none; background-color: transparent; color: rgb(51, 51, 51); font-family: &quot;Droid Sans&quot;,arial,sans-serif; font-size: 12.26px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;\">A confirmation email and a proof will be sent to this email address.<\/span><\/p>\n<\/div><div class='ginput_container ginput_container_email'>\n                            <input name='input_5' id='input_300_5' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_300_5\" \/>\n                        <\/div><\/div><div id=\"field_300_7\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_7'><span class='gform-field-label__text'>Telephone<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_7' id='input_300_7' type='tel' value='' class='medium'  placeholder='(999) 999-9999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/div><div id=\"field_300_6\" class=\"gfield gfield--type-email gfield--input-type-email field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_6'><span class='gform-field-label__text'>Student&#039;s Email<\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_6' id='input_300_6' type='email' value='' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_300_50\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  >Non-Member Sample Diploma\n<p><img data-recalc-dims=\"1\" decoding=\"async\" alt=\"\" src=\"https:\/\/i0.wp.com\/nche.com\/wp-content\/uploads\/2022\/10\/Non-Member-Sample.jpg?w=1080&#038;ssl=1\" style=\"float: left;\" \/><\/p>\n<p><\/P><\/font><\/div><fieldset id=\"field_300_43\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>NCHE Weekly Email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_300_43'>Would you like to receive our weekly homeschool news email? It is full of helpful and important information about homeschooling in NC!<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_300_43'>\n\t\t\t<div class='gchoice gchoice_300_43_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='Yes, please send me the email.'  id='choice_300_43_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_300_43\"   \/>\n\t\t\t\t\t<label for='choice_300_43_0' id='label_300_43_0' class='gform-field-label gform-field-label--type-inline'>Yes, please send me the email.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_300_43_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='No, not at this time.'  id='choice_300_43_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_300_43_1' id='label_300_43_1' class='gform-field-label gform-field-label--type-inline'>No, not at this time.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_300_43_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='I already receive the NCHE Weekly Email'  id='choice_300_43_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_300_43_2' id='label_300_43_2' class='gform-field-label gform-field-label--type-inline'>I already receive the NCHE Weekly Email<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_300_46\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Diploma Information<\/h3><\/div><div id=\"field_300_10\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  >The following information is used to produce the diploma. Please enter the required information as it should be formatted for the diploma.\n<\/div><div id=\"field_300_11\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_11'><span class='gform-field-label__text'>Name of Homeschool:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_300_11'><p><span style=\"display: inline !important; float: none; background-color: transparent; color: rgb(51, 51, 51); font-family: &quot;Droid Sans&quot;,arial,sans-serif; font-size: 16px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;\">The homeschool issuing the diploma, as filed with the North Carolina Division of Non-Public Education<\/span><\/p>\n\n<p><span style=\"display: inline !important; float: none; background-color: transparent; color: rgb(51, 51, 51); font-family: &quot;Droid Sans&quot;,arial,sans-serif; font-size: 16px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;\">Note: The school name will be printed in Old English Text MT. <b><span style=\"color:#990000\">For best results, don't use all caps.<\/b><\/span><\/span><\/p><\/div><div class='ginput_container ginput_container_text'><input name='input_11' id='input_300_11' type='text' value='' class='large'  aria-describedby=\"gfield_description_300_11\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_300_14\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Homeschool City and State:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_300_14'><p><span style=\"display: inline !important; float: none; background-color: transparent; color: rgb(51, 51, 51); font-family: &quot;Droid Sans&quot;,arial,sans-serif; font-size: 16px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;\">The city and state in which the school is located<\/span><\/p>\n<\/div>    \n                    <div class='ginput_complex ginput_container has_city has_state ginput_container_address gform-grid-row' id='input_300_14' >\n                        <span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_300_14_3_container' >\n                                    <label for='input_300_14_3' id='input_300_14_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_14.3' id='input_300_14_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_300_14_4_container' >\n                                        <label for='input_300_14_4' id='input_300_14_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                        <select name='input_14.4' id='input_300_14_4'     aria-required='true'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >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' selected='selected'>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><input type='hidden' class='gform_hidden' name='input_14.6' id='input_300_14_6' value='US' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_300_15\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Graduating Student&#039;s Name:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_300_15'><p>If the student has more than one middle name, add them to the middle name field.<\/p>\n<\/div><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name has_middle_name has_last_name has_suffix gf_name_has_4 ginput_container_name gform-grid-row' id='input_300_15'>\n                            \n                            <span id='input_300_15_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_300_15_3' class='gform-field-label gform-field-label--type-sub '>First Name<\/label>\n                                                    <input type='text' name='input_15.3' id='input_300_15_3' value=''   aria-required='true'     \/>\n                                                <\/span>\n                            <span id='input_300_15_4_container' class='name_middle gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_300_15_4' class='gform-field-label gform-field-label--type-sub '>Middle Name<\/label>\n                                                    <input type='text' name='input_15.4' id='input_300_15_4' value=''   aria-required='false'     \/>\n                                                <\/span>\n                            <span id='input_300_15_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_300_15_6' class='gform-field-label gform-field-label--type-sub '>Last Name<\/label>\n                                                            <input type='text' name='input_15.6' id='input_300_15_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            <span id='input_300_15_8_container' class='name_suffix  gform-grid-col gform-grid-col--size-auto' >\n                                                        <label for='input_300_15_8' class='gform-field-label gform-field-label--type-sub '>Suffix<\/label>\n                                                        <input type='text' name='input_15.8' id='input_300_15_8' value=''   aria-required='false'     \/>\n                                                    <\/span>\n                        <\/div><\/fieldset><div id=\"field_300_19\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_19'><span class='gform-field-label__text'>Graduation Month<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_19' id='input_300_19' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='January' >January<\/option><option value='February' >February<\/option><option value='March' >March<\/option><option value='April' >April<\/option><option value='May' >May<\/option><option value='June' >June<\/option><option value='July' >July<\/option><option value='August' >August<\/option><option value='September' >September<\/option><option value='October' >October<\/option><option value='November' >November<\/option><option value='December' >December<\/option><\/select><\/div><\/div><div id=\"field_300_18\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_18'><span class='gform-field-label__text'>Graduation Day<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_18' id='input_300_18' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='first' >first<\/option><option value='second' >second<\/option><option value='third' >third<\/option><option value='fourth' >fourth<\/option><option value='fifth' >fifth<\/option><option value='sixth' >sixth<\/option><option value='seventh' >seventh<\/option><option value='eighth' >eighth<\/option><option value='ninth' >ninth<\/option><option value='tenth' >tenth<\/option><option value='eleventh' >eleventh<\/option><option value='twelfth' >twelfth<\/option><option value='thirteenth' >thirteenth<\/option><option value='fourteenth' >fourteenth<\/option><option value='fifteenth' >fifteenth<\/option><option value='sixteenth' >sixteenth<\/option><option value='seventeenth' >seventeenth<\/option><option value='eighteenth' >eighteenth<\/option><option value='nineteenth' >nineteenth<\/option><option value='twentieth' >twentieth<\/option><option value='twenty-first' >twenty-first<\/option><option value='twenty-second' >twenty-second<\/option><option value='twenty-third' >twenty-third<\/option><option value='twenty-fourth' >twenty-fourth<\/option><option value='twenty-fifth' >twenty-fifth<\/option><option value='twenty-sixth' >twenty-sixth<\/option><option value='twenty-seventh' >twenty-seventh<\/option><option value='twenty-eighth' >twenty-eighth<\/option><option value='twenty-ninth' >twenty-ninth<\/option><option value='thirtieth' >thirtieth<\/option><option value='thirty-first' >thirty-first<\/option><\/select><\/div><\/div><div id=\"field_300_20\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_20'><span class='gform-field-label__text'>Graduation Year<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_20' id='input_300_20' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='two thousand' >two thousand<\/option><option value='two thousand one' >two thousand one<\/option><option value='two thousand two' >two thousand two<\/option><option value='two thousand three' >two thousand three<\/option><option value='two thousand four' >two thousand four<\/option><option value='two thousand five' >two thousand five<\/option><option value='two thousand six' >two thousand six<\/option><option value='two thousand seven' >two thousand seven<\/option><option value='two thousand eight' >two thousand eight<\/option><option value='two thousand nine' >two thousand nine<\/option><option value='two thousand ten' >two thousand ten<\/option><option value='two thousand eleven' >two thousand eleven<\/option><option value='two thousand twelve' >two thousand twelve<\/option><option value='two thousand thirteen' >two thousand thirteen<\/option><option value='two thousand fourteen' >two thousand fourteen<\/option><option value='two thousand fifteen' >two thousand fifteen<\/option><option value='two thousand sixteen' >two thousand sixteen<\/option><option value='two thousand seventeen' >two thousand seventeen<\/option><option value='two thousand eighteen' >two thousand eighteen<\/option><option value='two thousand nineteen' >two thousand nineteen<\/option><option value='two thousand twenty' >two thousand twenty<\/option><option value='two thousand twenty-one' >two thousand twenty-one<\/option><option value='two thousand twenty-two' >two thousand twenty-two<\/option><option value='two thousand twenty-three' >two thousand twenty-three<\/option><option value='two thousand twenty-four' >two thousand twenty-four<\/option><option value='two thousand twenty-five' >two thousand twenty-five<\/option><option value='two thousand twenty-six' >two thousand twenty-six<\/option><option value='two thousand twenty-seven' >two thousand twenty-seven<\/option><\/select><\/div><\/div><div id=\"field_300_21\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_21'><span class='gform-field-label__text'>Name of homeschool Chief Administrator<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_300_21'><p>The name listed with the North Carolina Division of Non-Public Education as you want it to appear on the diploma<\/p>\n<\/div><div class='ginput_container ginput_container_text'><input name='input_21' id='input_300_21' type='text' value='' class='medium'  aria-describedby=\"gfield_description_300_21\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_300_47\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Payment<\/h3><\/div><div id=\"field_300_22\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield_price gfield_price_300_22 gfield_product_300_22 gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_300_22_1'><span class='gform-field-label__text'>Diploma<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_22.1' value='Diploma' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_300_22' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_300_22' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Price:<\/label>\n\t\t\t\t\t\t<input type='text' readonly class='ginput_product_price gform-text-input-reset' name='input_22.2' id='ginput_base_price_300_22' value='$58.00' aria-label='Diploma Price'  \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_22.3' value='1' class='ginput_quantity_300_22 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_300_23\" class=\"gfield gfield--type-tax gfield--input-type-tax field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_23'><span class='gform-field-label__text'>6.75% Tax<\/span><\/label>\n            <div class='ginput_container'>\n                <span class='ginput_tax ginput_product_price ginput_tax_300_23'\n                \tstyle=''>$0.00<\/span>\n                <input type='hidden' name='input_23' id='input_300_23' class='gform_hidden ginput_tax_input' \n                    onchange='jQuery( this ).prev( \"span\" ).text( gformFormatMoney( this.value, true ) );' \n                    data-amount='6.75' data-amounttype='percent'\n                    data-productstype='include' data-products='[\"22\"]' \/>\n            <\/div><\/div><div id=\"field_300_25\" class=\"gfield gfield--type-tax gfield--input-type-tax field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_25'><span class='gform-field-label__text'>7% Tax<\/span><\/label>\n            <div class='ginput_container'>\n                <span class='ginput_tax ginput_product_price ginput_tax_300_25'\n                \tstyle=''>$0.00<\/span>\n                <input type='hidden' name='input_25' id='input_300_25' class='gform_hidden ginput_tax_input' \n                    onchange='jQuery( this ).prev( \"span\" ).text( gformFormatMoney( this.value, true ) );' \n                    data-amount='7' data-amounttype='percent'\n                    data-productstype='include' data-products='[\"22\"]' \/>\n            <\/div><\/div><div id=\"field_300_26\" class=\"gfield gfield--type-tax gfield--input-type-tax field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_26'><span class='gform-field-label__text'>7.25% Tax<\/span><\/label>\n            <div class='ginput_container'>\n                <span class='ginput_tax ginput_product_price ginput_tax_300_26'\n                \tstyle=''>$0.00<\/span>\n                <input type='hidden' name='input_26' id='input_300_26' class='gform_hidden ginput_tax_input' \n                    onchange='jQuery( this ).prev( \"span\" ).text( gformFormatMoney( this.value, true ) );' \n                    data-amount='7.25' data-amounttype='percent'\n                    data-productstype='include' data-products='[\"22\"]' \/>\n            <\/div><\/div><div id=\"field_300_27\" class=\"gfield gfield--type-tax gfield--input-type-tax field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_27'><span class='gform-field-label__text'>7.5% Tax<\/span><\/label>\n            <div class='ginput_container'>\n                <span class='ginput_tax ginput_product_price ginput_tax_300_27'\n                \tstyle=''>$0.00<\/span>\n                <input type='hidden' name='input_27' id='input_300_27' class='gform_hidden ginput_tax_input' \n                    onchange='jQuery( this ).prev( \"span\" ).text( gformFormatMoney( this.value, true ) );' \n                    data-amount='7.5' data-amounttype='percent'\n                    data-productstype='include' data-products='[\"22\"]' \/>\n            <\/div><\/div><div id=\"field_300_51\" class=\"gfield gfield--type-tax gfield--input-type-tax gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_51'><span class='gform-field-label__text'>8.25% Tax<\/span><\/label>\n            <div class='ginput_container'>\n                <span class='ginput_tax ginput_product_price ginput_tax_300_51'\n                \tstyle=''>$0.00<\/span>\n                <input type='hidden' name='input_51' id='input_300_51' class='gform_hidden ginput_tax_input' \n                    onchange='jQuery( this ).prev( \"span\" ).text( gformFormatMoney( this.value, true ) );' \n                    data-amount='8.25' data-amounttype='percent'\n                    data-productstype='include' data-products='[\"22\"]' \/>\n            <\/div><\/div><div id=\"field_300_34\" class=\"gfield gfield--type-total gfield--input-type-total gfield_price gfield_price_300_ gfield_total gfield_total_300_ field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  aria-atomic=\"true\" aria-live=\"polite\" ><label class='gfield_label gform-field-label' for='input_300_34'><span class='gform-field-label__text'>Total<\/span><\/label><div class='ginput_container ginput_container_total'>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_34' id='input_300_34' value='$0.00' class='gform-text-input-reset ginput_total ginput_total_300' \/>\n\t\t\t\t\t\t<\/div><\/div><fieldset id=\"field_300_37\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Refund Policy<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_300_37'>\n\t\t\t<div class='gchoice gchoice_300_37_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='I agree to the refund policy, &quot;cancelled orders will be issued a refund less incurred expenses.&quot;'  id='choice_300_37_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_300_37_0' id='label_300_37_0' class='gform-field-label gform-field-label--type-inline'>I agree to the refund policy, \"cancelled orders will be issued a refund less incurred expenses.\"<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_300_31\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Billing Address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    <div id='input_300_31_copy_values_option_container' class='copy_values_option_container' >\n                                        <input type='checkbox' id='input_300_31_copy_values_activated' class='copy_values_activated' value='1' data-source_field_id='30' data-source-field-label='Address' data-destination-field-label='Billing Address' name='input_31_copy_values_activated'  \/>\n                                        <label for='input_300_31_copy_values_activated' id='input_300_31_copy_values_option_label' class='copy_values_option_label inline gform-field-label gform-field-label--type-inline'>Billing address is same as above.<\/label>\n                                    <\/div>\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_300_31' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_300_31_1_container' >\n                                        <label for='input_300_31_1' id='input_300_31_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_31.1' id='input_300_31_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_300_31_2_container' >\n                                        <label for='input_300_31_2' id='input_300_31_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                        <input type='text' name='input_31.2' id='input_300_31_2' value=''     aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_300_31_3_container' >\n                                    <label for='input_300_31_3' id='input_300_31_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_31.3' id='input_300_31_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_300_31_4_container' >\n                                        <label for='input_300_31_4' id='input_300_31_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                        <select name='input_31.4' id='input_300_31_4'     aria-required='true'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >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' selected='selected'>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_300_31_5_container' >\n                                    <label for='input_300_31_5' id='input_300_31_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                    <input type='text' name='input_31.5' id='input_300_31_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_31.6' id='input_300_31_6' value='US' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_300_29\" class=\"gfield gfield--type-creditcard gfield--input-type-creditcard field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Credit Card<\/span><\/legend><div class='ginput_complex ginput_container ginput_container_creditcard gform-grid-row' id='input_300_29'><span class='ginput_full gform-grid-col' id='input_300_29_1_container' >\n                                    <div class='gform_card_icon_container'><div class='gform_card_icon gform_card_icon_amex' >American Express<\/div><div class='gform_card_icon gform_card_icon_discover' >Discover<\/div><div class='gform_card_icon gform_card_icon_mastercard' >MasterCard<\/div><div class='gform_card_icon gform_card_icon_visa' >Visa<\/div><span class='screen-reader-text' id='field_300_29_supported_creditcards'>Supported Credit Cards: American Express, Discover, MasterCard, Visa<\/span><\/div>\n                                    <label for='input_300_29_1' id='input_300_29_1_label' class='gform-field-label gform-field-label--type-sub '>Card Number<\/label>\n                                    <input type='text' name='input_29.1' id='input_300_29_1' value=''   onchange='gformMatchCard(\"input_300_29_1\");' onkeyup='gformMatchCard(\"input_300_29_1\");' autocomplete='off' pattern='[0-9]*' title='Only digits are allowed'  aria-required='false'  \/>\n                                 <\/span><span class='ginput_full ginput_cardextras gform-grid-col gform-grid-row' id='input_300_29_2_container'>\n                                            <fieldset class='ginput_cardinfo_left gform-grid-col' id='input_300_29_2_cardinfo_left'>\n                                            <legend class='gform-field-label gform-field-label--type-sub '>Expiration Date<\/legend>\n                                                <span class='ginput_card_expiration_container ginput_card_field gform-grid-row'>\n                                                   <span class='ginput_card_expiration_month_container gform-grid-col'>\n                                                       <label for='input_300_29_2_month' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Month<\/label>\n                                                       <select name='input_29.2[]' id='input_300_29_2_month'   class='ginput_card_expiration ginput_card_expiration_month' aria-required='false'  >\n                                                           <option value=''>Month<\/option><option value='1' >01<\/option><option value='2' >02<\/option><option value='3' >03<\/option><option value='4' >04<\/option><option value='5' >05<\/option><option value='6' >06<\/option><option value='7' >07<\/option><option value='8' >08<\/option><option value='9' >09<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option>\n                                                       <\/select>\n                                                   <\/span>\n                                                   <span class='ginput_card_expiration_year_container gform-grid-col'>\n                                                       <label for='input_300_29_2_year' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Year<\/label>\n                                                       <select name='input_29.2[]' id='input_300_29_2_year'   class='ginput_card_expiration ginput_card_expiration_year' aria-required='false'  >\n                                                           <option value=''>Year<\/option><option value='2026' >2026<\/option><option value='2027' >2027<\/option><option value='2028' >2028<\/option><option value='2029' >2029<\/option><option value='2030' >2030<\/option><option value='2031' >2031<\/option><option value='2032' >2032<\/option><option value='2033' >2033<\/option><option value='2034' >2034<\/option><option value='2035' >2035<\/option><option value='2036' >2036<\/option><option value='2037' >2037<\/option><option value='2038' >2038<\/option><option value='2039' >2039<\/option><option value='2040' >2040<\/option><option value='2041' >2041<\/option><option value='2042' >2042<\/option><option value='2043' >2043<\/option><option value='2044' >2044<\/option><option value='2045' >2045<\/option>\n                                                       <\/select>\n                                                   <\/span>\n                                                <\/span>\n                                            <\/fieldset><span class='ginput_cardinfo_right gform-grid-col' id='input_300_29_2_cardinfo_right'>\n                                                <label for='input_300_29_3' class='gform-field-label gform-field-label--type-sub '>Security Code<\/label>\n                                                <input type='text' name='input_29.3' id='input_300_29_3'   class='ginput_card_security_code' value='' autocomplete='off' pattern='[0-9]*' title='Only digits are allowed'  aria-required='false'  \/>\n                                                <span class='ginput_card_security_code_icon'>&nbsp;<\/span>\n                                             <\/span>\n                                        <\/span><span class='ginput_full gform-grid-col' id='input_300_29_5_container'>\n                                            <label for='input_300_29_5' id='input_300_29_5_label' class='gform-field-label gform-field-label--type-sub '>Cardholder Name<\/label>\n                                            <input type='text' name='input_29.5' id='input_300_29_5' value=''    aria-required='false'  \/>\n                                        <\/span> <\/div><\/fieldset><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <div class=\"gf-turnstile-container\"> <div id=\"cf-turnstile-gf-300\" class=\"cf-turnstile\" data-sitekey=\"0x4AAAAAAD2GVFzEN5GUCS3W\" data-theme=\"light\" data-language=\"auto\" data-size=\"normal\" data-retry=\"auto\" data-retry-interval=\"1000\" data-refresh-expired=\"auto\" data-refresh-timeout=\"auto\" data-action=\"gravity-form-300\" data-callback=\"turnstileGravityCallback\" data-appearance=\"always\"><\/div> <style>.gform_button { pointer-events: none; opacity: 0.5; }<\/style> <script data-jetpack-boost=\"ignore\" data-jetpack-boost=\"ignore\" data-cfasync=\"false\">(window.cfturnstileQueue=window.cfturnstileQueue||[]).push(\"-gf-300\");if(window.cfturnstileRender)window.cfturnstileRender();<\/script> <br class=\"cf-turnstile-br cf-turnstile-br-gf-300\"> <style>#cf-turnstile-gf-300 { margin-left: -15px; }<\/style> <\/div> <style> .gf-turnstile-container { width: 100%; } .gform_footer.top_label { display: flex; flex-wrap: wrap; } <\/style> <script data-jetpack-boost=\"ignore\" data-jetpack-boost=\"ignore\">document.addEventListener(\"DOMContentLoaded\", function() {document.addEventListener('gform\/post_render', function handlePostRender(event) {if (event.detail.formId !== 300) {return;}gform.utils.addAsyncFilter('gform\/submission\/pre_submission', async function handlePreSubmission(data) {document.addEventListener('gform\/post_render', function rerenderTurnstile(event) {if (event.detail.formId !== 300) {return;}const turnstileElement = document.getElementById('cf-turnstile-gf-300');if (turnstileElement) {turnstile.remove('#cf-turnstile-gf-300');turnstile.render('#cf-turnstile-gf-300', (typeof window.cfturnstileOpts === \"function\" ? window.cfturnstileOpts(turnstileElement) : {}));}document.removeEventListener('gform\/post_render', rerenderTurnstile);});gform.utils.removeFilter('gform\/submission\/pre_submission', handlePreSubmission);return data;});document.removeEventListener('gform\/post_render', handlePostRender);});});<\/script><button type='submit' id='gform_submit_button_300' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Submit<\/button> <button type='button'  id='gform_save_300_footer_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save and Continue Later<\/button>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_300' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_300' id='gform_theme_300' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_300' id='gform_style_settings_300' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_300' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='300' \/>\n            <input type='hidden' class='gform_hidden' name='gform_save' id='gform_save_300' value='' \/>\n                             <input type='hidden' class='gform_hidden' name='gform_resume_token' id='gform_resume_token_300' value='' \/>\n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='au2NDlNNT44JMcEMdDKaLU\/fia7kaEY9pv2S5WhBNRU2TUvhGDbXqOV3n6NiaZzqMGYez6V13G3s7jEJrP719aVuubzxFc9L7hEX1b0fN5fXq2A=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' 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value='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' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_300' id='gform_target_page_number_300' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_300' id='gform_source_page_number_300' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_3&#8243; _builder_version=&#8221;4.27.3&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_sidebar area=&#8221;et_pb_widget_area_21&#8243; _builder_version=&#8221;4.27.3&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_sidebar][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"\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_300' style='display:none'>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Diploma Order Form (Nonmember)<\/h2>\n                            <p class='gform_description'><\/p>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_300'  action='\/vi\/wp-json\/wp\/v2\/pages\/47452' data-formid='300' novalidate>\t\t\t\t\t<div style=\"display: none !important;\" class=\"akismet-fields-container gf_invisible\" data-prefix=\"ak_\">\n\t\t\t\t\t\t<label>&#916;<textarea name=\"ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label>\n\t\t\t\t\t\t<input type=\"hidden\" id=\"ak_js_2\" name=\"ak_js\" value=\"191\" \/>\n\t\t\t\t\t\t<script data-jetpack-boost=\"ignore\">\ndocument.getElementById( \"ak_js_2\" ).setAttribute( \"value\", ( new Date() ).getTime() );\n<\/script>\n\n\t\t\t\t\t<\/div>\n                        <div class='gform-body gform_body'><div id='gform_fields_300' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_300_44\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Contact Information<\/h3><\/div><div id=\"field_300_36\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_36' id='input_300_36' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><fieldset id=\"field_300_42\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Is this your first time registering for an event or activity or your first transaction with NCHE?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_300_42'>Please select yes or no.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_300_42'>\n\t\t\t<div class='gchoice gchoice_300_42_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='Yes'  id='choice_300_42_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_300_42\"   \/>\n\t\t\t\t\t<label for='choice_300_42_0' id='label_300_42_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_300_42_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='No'  id='choice_300_42_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_300_42_1' id='label_300_42_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_300_3\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Primary Contact Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_300_3'><p><span style=\"display: inline !important; float: none; background-color: transparent; color: rgb(51, 51, 51); font-family: &quot;Droid Sans&quot;,arial,sans-serif; font-size: 12.26px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;\">Parent, legal guardian or member of the household<\/span><\/p>\n<\/div><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_300_3'>\n                            \n                            <span id='input_300_3_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_300_3_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_3.3' id='input_300_3_3' value=''   aria-required='true'     \/>\n                                                <\/span>\n                            \n                            <span id='input_300_3_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_300_3_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_3.6' id='input_300_3_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_300_30\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \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_300_30' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_300_30_1_container' >\n                                        <label for='input_300_30_1' id='input_300_30_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_30.1' id='input_300_30_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_300_30_2_container' >\n                                        <label for='input_300_30_2' id='input_300_30_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                        <input type='text' name='input_30.2' id='input_300_30_2' value=''     aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_300_30_3_container' >\n                                    <label for='input_300_30_3' id='input_300_30_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_30.3' id='input_300_30_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_300_30_4_container' >\n                                        <label for='input_300_30_4' id='input_300_30_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                        <select name='input_30.4' id='input_300_30_4'     aria-required='true'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >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' selected='selected'>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_300_30_5_container' >\n                                    <label for='input_300_30_5' id='input_300_30_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                    <input type='text' name='input_30.5' id='input_300_30_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_30.6' id='input_300_30_6' value='US' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_300_24\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_24'><span class='gform-field-label__text'>North Carolina County in which the homeschool is located<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_24' id='input_300_24' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='Alamance County' >Alamance County<\/option><option value='Alexander County' >Alexander County<\/option><option value='Alleghany County' >Alleghany County<\/option><option value='Anson County' >Anson County<\/option><option value='Ashe County' >Ashe County<\/option><option value='Avery County' >Avery County<\/option><option value='Beaufort County' >Beaufort County<\/option><option value='Bertie County' >Bertie County<\/option><option value='Bladen County' >Bladen County<\/option><option value='Brunswick County' >Brunswick County<\/option><option value='Buncombe County' >Buncombe County<\/option><option value='Burke County' >Burke County<\/option><option value='Cabarrus County' >Cabarrus County<\/option><option value='Caldwell County' >Caldwell County<\/option><option value='Camden County' >Camden County<\/option><option value='Carteret County' >Carteret County<\/option><option value='Caswell County' >Caswell County<\/option><option value='Catawba County' >Catawba County<\/option><option value='Chatham County' >Chatham County<\/option><option value='Cherokee County' >Cherokee County<\/option><option value='Chowan County' >Chowan County<\/option><option value='Clay County' >Clay County<\/option><option value='Cleveland County' >Cleveland County<\/option><option value='Columbus County' >Columbus County<\/option><option value='Craven County' >Craven County<\/option><option value='Cumberland County' >Cumberland County<\/option><option value='Currituck County' >Currituck County<\/option><option value='Dare County' >Dare County<\/option><option value='Davidson County' >Davidson County<\/option><option value='Davie County' >Davie County<\/option><option value='Duplin County' >Duplin County<\/option><option value='Durham County' >Durham County<\/option><option value='Edgecombe County' >Edgecombe County<\/option><option value='Forsyth County' >Forsyth County<\/option><option value='Franklin County' >Franklin County<\/option><option value='Gaston County' >Gaston County<\/option><option value='Gates County' >Gates County<\/option><option value='Graham County' >Graham County<\/option><option value='Granville County' >Granville County<\/option><option value='Greene County' >Greene County<\/option><option value='Guilford County' >Guilford County<\/option><option value='Halifax County' >Halifax County<\/option><option value='Harnett County' >Harnett County<\/option><option value='Haywood County' >Haywood County<\/option><option value='Henderson County' >Henderson County<\/option><option value='Hertford County' >Hertford County<\/option><option value='Hoke County' >Hoke County<\/option><option value='Hyde County' >Hyde County<\/option><option value='Iredell County' >Iredell County<\/option><option value='Jackson County' >Jackson County<\/option><option value='Johnston County' >Johnston County<\/option><option value='Jones County' >Jones County<\/option><option value='Lee County' >Lee County<\/option><option value='Lenoir County' >Lenoir County<\/option><option value='Lincoln County' >Lincoln County<\/option><option value='McDowell County' >McDowell County<\/option><option value='Macon County' >Macon County<\/option><option value='Madison County' >Madison County<\/option><option value='Martin County' >Martin County<\/option><option value='Mecklenburg County' >Mecklenburg County<\/option><option value='Mitchell County' >Mitchell County<\/option><option value='Montgomery County' >Montgomery County<\/option><option value='Moore County' >Moore County<\/option><option value='Nash County' >Nash County<\/option><option value='New Hanover County' >New Hanover County<\/option><option value='Northampton County' >Northampton County<\/option><option value='Onslow County' >Onslow County<\/option><option value='Orange County' >Orange County<\/option><option value='Pamlico County' >Pamlico County<\/option><option value='Pasquotank County' >Pasquotank County<\/option><option value='Pender County' >Pender County<\/option><option value='Perquimans County' >Perquimans County<\/option><option value='Person County' >Person County<\/option><option value='Pitt County' >Pitt County<\/option><option value='Polk County' >Polk County<\/option><option value='Randolph County' >Randolph County<\/option><option value='Richmond County' >Richmond County<\/option><option value='Robeson County' >Robeson County<\/option><option value='Rockingham County' >Rockingham County<\/option><option value='Rowan County' >Rowan County<\/option><option value='Rutherford County' >Rutherford County<\/option><option value='Sampson County' >Sampson County<\/option><option value='Scotland County' >Scotland County<\/option><option value='Stanly County' >Stanly County<\/option><option value='Stokes County' >Stokes County<\/option><option value='Surry County' >Surry County<\/option><option value='Swain County' >Swain County<\/option><option value='Transylvania County' >Transylvania County<\/option><option value='Tyrrell County' >Tyrrell County<\/option><option value='Union County' >Union County<\/option><option value='Vance County' >Vance County<\/option><option value='Wake County' >Wake County<\/option><option value='Warren County' >Warren County<\/option><option value='Washington County' >Washington County<\/option><option value='Watauga County' >Watauga County<\/option><option value='Wayne County' >Wayne County<\/option><option value='Wilkes County' >Wilkes County<\/option><option value='Wilson County' >Wilson County<\/option><option value='Yadkin County' >Yadkin County<\/option><option value='Yancey County' >Yancey County<\/option><\/select><\/div><\/div><div id=\"field_300_5\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_5'><span class='gform-field-label__text'>Primary Contact Email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_300_5'><p><span style=\"display: inline !important; float: none; background-color: transparent; color: rgb(51, 51, 51); font-family: &quot;Droid Sans&quot;,arial,sans-serif; font-size: 12.26px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;\">A confirmation email and a proof will be sent to this email address.<\/span><\/p>\n<\/div><div class='ginput_container ginput_container_email'>\n                            <input name='input_5' id='input_300_5' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_300_5\" \/>\n                        <\/div><\/div><div id=\"field_300_7\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_7'><span class='gform-field-label__text'>Telephone<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_7' id='input_300_7' type='tel' value='' class='medium'  placeholder='(999) 999-9999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/div><div id=\"field_300_6\" class=\"gfield gfield--type-email gfield--input-type-email field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_6'><span class='gform-field-label__text'>Student&#039;s Email<\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_6' id='input_300_6' type='email' value='' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_300_50\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  >Non-Member Sample Diploma\n<p><img decoding=\"async\" alt=\"\" src=\"https:\/\/nche.com\/wp-content\/uploads\/2022\/10\/Non-Member-Sample.jpg\" style=\"float: left;\" \/><\/p>\n<p><\/P><\/font><\/div><fieldset id=\"field_300_43\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>NCHE Weekly Email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_300_43'>Would you like to receive our weekly homeschool news email? It is full of helpful and important information about homeschooling in NC!<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_300_43'>\n\t\t\t<div class='gchoice gchoice_300_43_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='Yes, please send me the email.'  id='choice_300_43_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_300_43\"   \/>\n\t\t\t\t\t<label for='choice_300_43_0' id='label_300_43_0' class='gform-field-label gform-field-label--type-inline'>Yes, please send me the email.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_300_43_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='No, not at this time.'  id='choice_300_43_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_300_43_1' id='label_300_43_1' class='gform-field-label gform-field-label--type-inline'>No, not at this time.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_300_43_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='I already receive the NCHE Weekly Email'  id='choice_300_43_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_300_43_2' id='label_300_43_2' class='gform-field-label gform-field-label--type-inline'>I already receive the NCHE Weekly Email<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_300_46\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Diploma Information<\/h3><\/div><div id=\"field_300_10\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  >The following information is used to produce the diploma. Please enter the required information as it should be formatted for the diploma.\n<\/div><div id=\"field_300_11\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_11'><span class='gform-field-label__text'>Name of Homeschool:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_300_11'><p><span style=\"display: inline !important; float: none; background-color: transparent; color: rgb(51, 51, 51); font-family: &quot;Droid Sans&quot;,arial,sans-serif; font-size: 16px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;\">The homeschool issuing the diploma, as filed with the North Carolina Division of Non-Public Education<\/span><\/p>\n\n<p><span style=\"display: inline !important; float: none; background-color: transparent; color: rgb(51, 51, 51); font-family: &quot;Droid Sans&quot;,arial,sans-serif; font-size: 16px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;\">Note: The school name will be printed in Old English Text MT. <b><span style=\"color:#990000\">For best results, don't use all caps.<\/b><\/span><\/span><\/p><\/div><div class='ginput_container ginput_container_text'><input name='input_11' id='input_300_11' type='text' value='' class='large'  aria-describedby=\"gfield_description_300_11\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_300_14\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Homeschool City and State:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_300_14'><p><span style=\"display: inline !important; float: none; background-color: transparent; color: rgb(51, 51, 51); font-family: &quot;Droid Sans&quot;,arial,sans-serif; font-size: 16px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;\">The city and state in which the school is located<\/span><\/p>\n<\/div>    \n                    <div class='ginput_complex ginput_container has_city has_state ginput_container_address gform-grid-row' id='input_300_14' >\n                        <span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_300_14_3_container' >\n                                    <label for='input_300_14_3' id='input_300_14_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_14.3' id='input_300_14_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_300_14_4_container' >\n                                        <label for='input_300_14_4' id='input_300_14_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                        <select name='input_14.4' id='input_300_14_4'     aria-required='true'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >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' selected='selected'>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><input type='hidden' class='gform_hidden' name='input_14.6' id='input_300_14_6' value='US' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_300_15\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Graduating Student&#039;s Name:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_300_15'><p>If the student has more than one middle name, add them to the middle name field.<\/p>\n<\/div><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name has_middle_name has_last_name has_suffix gf_name_has_4 ginput_container_name gform-grid-row' id='input_300_15'>\n                            \n                            <span id='input_300_15_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_300_15_3' class='gform-field-label gform-field-label--type-sub '>First Name<\/label>\n                                                    <input type='text' name='input_15.3' id='input_300_15_3' value=''   aria-required='true'     \/>\n                                                <\/span>\n                            <span id='input_300_15_4_container' class='name_middle gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_300_15_4' class='gform-field-label gform-field-label--type-sub '>Middle Name<\/label>\n                                                    <input type='text' name='input_15.4' id='input_300_15_4' value=''   aria-required='false'     \/>\n                                                <\/span>\n                            <span id='input_300_15_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_300_15_6' class='gform-field-label gform-field-label--type-sub '>Last Name<\/label>\n                                                            <input type='text' name='input_15.6' id='input_300_15_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            <span id='input_300_15_8_container' class='name_suffix  gform-grid-col gform-grid-col--size-auto' >\n                                                        <label for='input_300_15_8' class='gform-field-label gform-field-label--type-sub '>Suffix<\/label>\n                                                        <input type='text' name='input_15.8' id='input_300_15_8' value=''   aria-required='false'     \/>\n                                                    <\/span>\n                        <\/div><\/fieldset><div id=\"field_300_19\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_19'><span class='gform-field-label__text'>Graduation Month<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_19' id='input_300_19' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='January' >January<\/option><option value='February' >February<\/option><option value='March' >March<\/option><option value='April' >April<\/option><option value='May' >May<\/option><option value='June' >June<\/option><option value='July' >July<\/option><option value='August' >August<\/option><option value='September' >September<\/option><option value='October' >October<\/option><option value='November' >November<\/option><option value='December' >December<\/option><\/select><\/div><\/div><div id=\"field_300_18\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_18'><span class='gform-field-label__text'>Graduation Day<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_18' id='input_300_18' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='first' >first<\/option><option value='second' >second<\/option><option value='third' >third<\/option><option value='fourth' >fourth<\/option><option value='fifth' >fifth<\/option><option value='sixth' >sixth<\/option><option value='seventh' >seventh<\/option><option value='eighth' >eighth<\/option><option value='ninth' >ninth<\/option><option value='tenth' >tenth<\/option><option value='eleventh' >eleventh<\/option><option value='twelfth' >twelfth<\/option><option value='thirteenth' >thirteenth<\/option><option value='fourteenth' >fourteenth<\/option><option value='fifteenth' >fifteenth<\/option><option value='sixteenth' >sixteenth<\/option><option value='seventeenth' >seventeenth<\/option><option value='eighteenth' >eighteenth<\/option><option value='nineteenth' >nineteenth<\/option><option value='twentieth' >twentieth<\/option><option value='twenty-first' >twenty-first<\/option><option value='twenty-second' >twenty-second<\/option><option value='twenty-third' >twenty-third<\/option><option value='twenty-fourth' >twenty-fourth<\/option><option value='twenty-fifth' >twenty-fifth<\/option><option value='twenty-sixth' >twenty-sixth<\/option><option value='twenty-seventh' >twenty-seventh<\/option><option value='twenty-eighth' >twenty-eighth<\/option><option value='twenty-ninth' >twenty-ninth<\/option><option value='thirtieth' >thirtieth<\/option><option value='thirty-first' >thirty-first<\/option><\/select><\/div><\/div><div id=\"field_300_20\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_20'><span class='gform-field-label__text'>Graduation Year<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_20' id='input_300_20' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='two thousand' >two thousand<\/option><option value='two thousand one' >two thousand one<\/option><option value='two thousand two' >two thousand two<\/option><option value='two thousand three' >two thousand three<\/option><option value='two thousand four' >two thousand four<\/option><option value='two thousand five' >two thousand five<\/option><option value='two thousand six' >two thousand six<\/option><option value='two thousand seven' >two thousand seven<\/option><option value='two thousand eight' >two thousand eight<\/option><option value='two thousand nine' >two thousand nine<\/option><option value='two thousand ten' >two thousand ten<\/option><option value='two thousand eleven' >two thousand eleven<\/option><option value='two thousand twelve' >two thousand twelve<\/option><option value='two thousand thirteen' >two thousand thirteen<\/option><option value='two thousand fourteen' >two thousand fourteen<\/option><option value='two thousand fifteen' >two thousand fifteen<\/option><option value='two thousand sixteen' >two thousand sixteen<\/option><option value='two thousand seventeen' >two thousand seventeen<\/option><option value='two thousand eighteen' >two thousand eighteen<\/option><option value='two thousand nineteen' >two thousand nineteen<\/option><option value='two thousand twenty' >two thousand twenty<\/option><option value='two thousand twenty-one' >two thousand twenty-one<\/option><option value='two thousand twenty-two' >two thousand twenty-two<\/option><option value='two thousand twenty-three' >two thousand twenty-three<\/option><option value='two thousand twenty-four' >two thousand twenty-four<\/option><option value='two thousand twenty-five' >two thousand twenty-five<\/option><option value='two thousand twenty-six' >two thousand twenty-six<\/option><option value='two thousand twenty-seven' >two thousand twenty-seven<\/option><\/select><\/div><\/div><div id=\"field_300_21\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_21'><span class='gform-field-label__text'>Name of homeschool Chief Administrator<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_300_21'><p>The name listed with the North Carolina Division of Non-Public Education as you want it to appear on the diploma<\/p>\n<\/div><div class='ginput_container ginput_container_text'><input name='input_21' id='input_300_21' type='text' value='' class='medium'  aria-describedby=\"gfield_description_300_21\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_300_47\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Payment<\/h3><\/div><div id=\"field_300_22\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield_price gfield_price_300_22 gfield_product_300_22 gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_300_22_1'><span class='gform-field-label__text'>Diploma<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_22.1' value='Diploma' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_300_22' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_300_22' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Price:<\/label>\n\t\t\t\t\t\t<input type='text' readonly class='ginput_product_price gform-text-input-reset' name='input_22.2' id='ginput_base_price_300_22' value='$58.00' aria-label='Diploma Price'  \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_22.3' value='1' class='ginput_quantity_300_22 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_300_23\" class=\"gfield gfield--type-tax gfield--input-type-tax field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_23'><span class='gform-field-label__text'>6.75% Tax<\/span><\/label>\n            <div class='ginput_container'>\n                <span class='ginput_tax ginput_product_price ginput_tax_300_23'\n                \tstyle=''>$0.00<\/span>\n                <input type='hidden' name='input_23' id='input_300_23' class='gform_hidden ginput_tax_input' \n                    onchange='jQuery( this ).prev( \"span\" ).text( gformFormatMoney( this.value, true ) );' \n                    data-amount='6.75' data-amounttype='percent'\n                    data-productstype='include' data-products='[\"22\"]' \/>\n            <\/div><\/div><div id=\"field_300_25\" class=\"gfield gfield--type-tax gfield--input-type-tax field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_25'><span class='gform-field-label__text'>7% Tax<\/span><\/label>\n            <div class='ginput_container'>\n                <span class='ginput_tax ginput_product_price ginput_tax_300_25'\n                \tstyle=''>$0.00<\/span>\n                <input type='hidden' name='input_25' id='input_300_25' class='gform_hidden ginput_tax_input' \n                    onchange='jQuery( this ).prev( \"span\" ).text( gformFormatMoney( this.value, true ) );' \n                    data-amount='7' data-amounttype='percent'\n                    data-productstype='include' data-products='[\"22\"]' \/>\n            <\/div><\/div><div id=\"field_300_26\" class=\"gfield gfield--type-tax gfield--input-type-tax field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_26'><span class='gform-field-label__text'>7.25% Tax<\/span><\/label>\n            <div class='ginput_container'>\n                <span class='ginput_tax ginput_product_price ginput_tax_300_26'\n                \tstyle=''>$0.00<\/span>\n                <input type='hidden' name='input_26' id='input_300_26' class='gform_hidden ginput_tax_input' \n                    onchange='jQuery( this ).prev( \"span\" ).text( gformFormatMoney( this.value, true ) );' \n                    data-amount='7.25' data-amounttype='percent'\n                    data-productstype='include' data-products='[\"22\"]' \/>\n            <\/div><\/div><div id=\"field_300_27\" class=\"gfield gfield--type-tax gfield--input-type-tax field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_27'><span class='gform-field-label__text'>7.5% Tax<\/span><\/label>\n            <div class='ginput_container'>\n                <span class='ginput_tax ginput_product_price ginput_tax_300_27'\n                \tstyle=''>$0.00<\/span>\n                <input type='hidden' name='input_27' id='input_300_27' class='gform_hidden ginput_tax_input' \n                    onchange='jQuery( this ).prev( \"span\" ).text( gformFormatMoney( this.value, true ) );' \n                    data-amount='7.5' data-amounttype='percent'\n                    data-productstype='include' data-products='[\"22\"]' \/>\n            <\/div><\/div><div id=\"field_300_51\" class=\"gfield gfield--type-tax gfield--input-type-tax gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_300_51'><span class='gform-field-label__text'>8.25% Tax<\/span><\/label>\n            <div class='ginput_container'>\n                <span class='ginput_tax ginput_product_price ginput_tax_300_51'\n                \tstyle=''>$0.00<\/span>\n                <input type='hidden' name='input_51' id='input_300_51' class='gform_hidden ginput_tax_input' \n                    onchange='jQuery( this ).prev( \"span\" ).text( gformFormatMoney( this.value, true ) );' \n                    data-amount='8.25' data-amounttype='percent'\n                    data-productstype='include' data-products='[\"22\"]' \/>\n            <\/div><\/div><div id=\"field_300_34\" class=\"gfield gfield--type-total gfield--input-type-total gfield_price gfield_price_300_ gfield_total gfield_total_300_ field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  aria-atomic=\"true\" aria-live=\"polite\" ><label class='gfield_label gform-field-label' for='input_300_34'><span class='gform-field-label__text'>Total<\/span><\/label><div class='ginput_container ginput_container_total'>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_34' id='input_300_34' value='$0.00' class='gform-text-input-reset ginput_total ginput_total_300' \/>\n\t\t\t\t\t\t<\/div><\/div><fieldset id=\"field_300_37\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Refund Policy<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_300_37'>\n\t\t\t<div class='gchoice gchoice_300_37_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='I agree to the refund policy, &quot;cancelled orders will be issued a refund less incurred expenses.&quot;'  id='choice_300_37_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_300_37_0' id='label_300_37_0' class='gform-field-label gform-field-label--type-inline'>I agree to the refund policy, \"cancelled orders will be issued a refund less incurred expenses.\"<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_300_31\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Billing Address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    <div id='input_300_31_copy_values_option_container' class='copy_values_option_container' >\n                                        <input type='checkbox' id='input_300_31_copy_values_activated' class='copy_values_activated' value='1' data-source_field_id='30' data-source-field-label='Address' data-destination-field-label='Billing Address' name='input_31_copy_values_activated'  \/>\n                                        <label for='input_300_31_copy_values_activated' id='input_300_31_copy_values_option_label' class='copy_values_option_label inline gform-field-label gform-field-label--type-inline'>Billing address is same as above.<\/label>\n                                    <\/div>\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_300_31' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_300_31_1_container' >\n                                        <label for='input_300_31_1' id='input_300_31_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_31.1' id='input_300_31_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_300_31_2_container' >\n                                        <label for='input_300_31_2' id='input_300_31_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                        <input type='text' name='input_31.2' id='input_300_31_2' value=''     aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_300_31_3_container' >\n                                    <label for='input_300_31_3' id='input_300_31_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_31.3' id='input_300_31_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_300_31_4_container' >\n                                        <label for='input_300_31_4' id='input_300_31_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                        <select name='input_31.4' id='input_300_31_4'     aria-required='true'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >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' selected='selected'>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_300_31_5_container' >\n                                    <label for='input_300_31_5' id='input_300_31_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                    <input type='text' name='input_31.5' id='input_300_31_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_31.6' id='input_300_31_6' value='US' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_300_29\" class=\"gfield gfield--type-creditcard gfield--input-type-creditcard field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Credit Card<\/span><\/legend><div class='ginput_complex ginput_container ginput_container_creditcard gform-grid-row' id='input_300_29'><span class='ginput_full gform-grid-col' id='input_300_29_1_container' >\n                                    <div class='gform_card_icon_container'><div class='gform_card_icon gform_card_icon_amex' >American Express<\/div><div class='gform_card_icon gform_card_icon_discover' >Discover<\/div><div class='gform_card_icon gform_card_icon_mastercard' >MasterCard<\/div><div class='gform_card_icon gform_card_icon_visa' >Visa<\/div><span class='screen-reader-text' id='field_300_29_supported_creditcards'>Supported Credit Cards: American Express, Discover, MasterCard, Visa<\/span><\/div>\n                                    <label for='input_300_29_1' id='input_300_29_1_label' class='gform-field-label gform-field-label--type-sub '>Card Number<\/label>\n                                    <input type='text' name='input_29.1' id='input_300_29_1' value=''   onchange='gformMatchCard(\"input_300_29_1\");' onkeyup='gformMatchCard(\"input_300_29_1\");' autocomplete='off' pattern='[0-9]*' title='Only digits are allowed'  aria-required='false'  \/>\n                                 <\/span><span class='ginput_full ginput_cardextras gform-grid-col gform-grid-row' id='input_300_29_2_container'>\n                                            <fieldset class='ginput_cardinfo_left gform-grid-col' id='input_300_29_2_cardinfo_left'>\n                                            <legend class='gform-field-label gform-field-label--type-sub '>Expiration Date<\/legend>\n                                                <span class='ginput_card_expiration_container ginput_card_field gform-grid-row'>\n                                                   <span class='ginput_card_expiration_month_container gform-grid-col'>\n                                                       <label for='input_300_29_2_month' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Month<\/label>\n                                                       <select name='input_29.2[]' id='input_300_29_2_month'   class='ginput_card_expiration ginput_card_expiration_month' aria-required='false'  >\n                                                           <option value=''>Month<\/option><option value='1' >01<\/option><option value='2' >02<\/option><option value='3' >03<\/option><option value='4' >04<\/option><option value='5' >05<\/option><option value='6' >06<\/option><option value='7' >07<\/option><option value='8' >08<\/option><option value='9' >09<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option>\n                                                       <\/select>\n                                                   <\/span>\n                                                   <span class='ginput_card_expiration_year_container gform-grid-col'>\n                                                       <label for='input_300_29_2_year' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Year<\/label>\n                                                       <select name='input_29.2[]' id='input_300_29_2_year'   class='ginput_card_expiration ginput_card_expiration_year' aria-required='false'  >\n                                                           <option value=''>Year<\/option><option value='2026' >2026<\/option><option value='2027' >2027<\/option><option value='2028' >2028<\/option><option value='2029' >2029<\/option><option value='2030' >2030<\/option><option value='2031' >2031<\/option><option value='2032' >2032<\/option><option value='2033' >2033<\/option><option value='2034' >2034<\/option><option value='2035' >2035<\/option><option value='2036' >2036<\/option><option value='2037' >2037<\/option><option value='2038' >2038<\/option><option value='2039' >2039<\/option><option value='2040' >2040<\/option><option value='2041' >2041<\/option><option value='2042' >2042<\/option><option value='2043' >2043<\/option><option value='2044' >2044<\/option><option value='2045' >2045<\/option>\n                                                       <\/select>\n                                                   <\/span>\n                                                <\/span>\n                                            <\/fieldset><span class='ginput_cardinfo_right gform-grid-col' id='input_300_29_2_cardinfo_right'>\n                                                <label for='input_300_29_3' class='gform-field-label gform-field-label--type-sub '>Security Code<\/label>\n                                                <input type='text' name='input_29.3' id='input_300_29_3'   class='ginput_card_security_code' value='' autocomplete='off' pattern='[0-9]*' title='Only digits are allowed'  aria-required='false'  \/>\n                                                <span class='ginput_card_security_code_icon'>&nbsp;<\/span>\n                                             <\/span>\n                                        <\/span><span class='ginput_full gform-grid-col' id='input_300_29_5_container'>\n                                            <label for='input_300_29_5' id='input_300_29_5_label' class='gform-field-label gform-field-label--type-sub '>Cardholder Name<\/label>\n                                            <input type='text' name='input_29.5' id='input_300_29_5' value=''    aria-required='false'  \/>\n                                        <\/span> <\/div><\/fieldset><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <div class=\"gf-turnstile-container\"> <div id=\"cf-turnstile-gf-300\" class=\"cf-turnstile\" data-sitekey=\"0x4AAAAAAD2GVFzEN5GUCS3W\" data-theme=\"light\" data-language=\"auto\" data-size=\"normal\" data-retry=\"auto\" data-retry-interval=\"1000\" data-refresh-expired=\"auto\" data-refresh-timeout=\"auto\" data-action=\"gravity-form-300\" data-callback=\"turnstileGravityCallback\" data-appearance=\"always\"><\/div> <style>.gform_button { pointer-events: none; opacity: 0.5; }<\/style> <script data-jetpack-boost=\"ignore\" data-jetpack-boost=\"ignore\" data-cfasync=\"false\">(window.cfturnstileQueue=window.cfturnstileQueue||[]).push(\"-gf-300\");if(window.cfturnstileRender)window.cfturnstileRender();<\/script> <br class=\"cf-turnstile-br cf-turnstile-br-gf-300\"> <style>#cf-turnstile-gf-300 { margin-left: -15px; }<\/style> <\/div> <style> .gf-turnstile-container { width: 100%; } .gform_footer.top_label { display: flex; flex-wrap: wrap; } <\/style> <script data-jetpack-boost=\"ignore\" data-jetpack-boost=\"ignore\">document.addEventListener(\"DOMContentLoaded\", function() {document.addEventListener('gform\/post_render', function handlePostRender(event) {if (event.detail.formId !== 300) {return;}gform.utils.addAsyncFilter('gform\/submission\/pre_submission', async function handlePreSubmission(data) {document.addEventListener('gform\/post_render', function rerenderTurnstile(event) {if (event.detail.formId !== 300) {return;}const turnstileElement = document.getElementById('cf-turnstile-gf-300');if (turnstileElement) {turnstile.remove('#cf-turnstile-gf-300');turnstile.render('#cf-turnstile-gf-300', (typeof window.cfturnstileOpts === \"function\" ? window.cfturnstileOpts(turnstileElement) : {}));}document.removeEventListener('gform\/post_render', rerenderTurnstile);});gform.utils.removeFilter('gform\/submission\/pre_submission', handlePreSubmission);return data;});document.removeEventListener('gform\/post_render', handlePostRender);});});<\/script><button type='submit' id='gform_submit_button_300' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Submit<\/button> <button type='button'  id='gform_save_300_footer_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save and Continue Later<\/button>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_300' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_300' id='gform_theme_300' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_300' id='gform_style_settings_300' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_300' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='300' \/>\n            <input type='hidden' class='gform_hidden' name='gform_save' id='gform_save_300' value='' \/>\n                             <input type='hidden' class='gform_hidden' name='gform_resume_token' id='gform_resume_token_300' value='' \/>\n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='BrQcWAiCCqzxZhdYlIZALpkfu3hR9IHV37novaxbzFm26yrV7ZLuBSClPa36VEc9v1G0xX5IBPsLJ7c6j7zvVEOPSI\/7DPu6C6boUk2DKbTUFd4=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_300' 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