{"id":27604,"date":"2026-02-17T10:27:38","date_gmt":"2026-02-17T15:27:38","guid":{"rendered":"https:\/\/cpata-cabamc.ca\/?page_id=27604"},"modified":"2026-02-17T10:28:37","modified_gmt":"2026-02-17T15:28:37","slug":"working-group-to-develop-supervised-practice-resources-intake-form","status":"publish","type":"page","link":"https:\/\/cpata-cabamc.ca\/en\/working-group-to-develop-supervised-practice-resources-intake-form\/","title":{"rendered":"Working Group to Develop Supervised Practice Resources &#8211; Intake Form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"27604\" class=\"elementor elementor-27604\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-1ae58d8 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"1ae58d8\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-e91dfad\" data-id=\"e91dfad\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-139dcc2 uael-gf-ajax-true uael-gf-style-box uael-gf-input-size-sm uael-gf-enable-classes-no uael-gf-button-left uael-gf-btn-size-sm elementor-widget elementor-widget-uael-gf-styler\" data-id=\"139dcc2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"uael-gf-styler.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"uael-gf-style uael-gf-check-style elementor-clickable\">\n\t<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_48' style='display:none'><form method='post' enctype='multipart\/form-data'  id='gform_48'  action='\/en\/wp-json\/wp\/v2\/pages\/27604' data-formid='48' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_48' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_48_56\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_48_56'>Facebook<\/label><div class='ginput_container'><input name='input_56' id='input_48_56' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_48_56'>This field is for validation purposes and should be left unchanged.<\/div><\/div><div id=\"field_48_49\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >In 2024, CPATA undertook a consultation on the pathways to licensure to better understand the strengths and challenges of the supervised practice training model. This was followed by a survey of trainees and supervisors in 2025 to see how agents in training are exposed to competencies as well as supervision and workplace strengths. As a result of the findings, CPATA will be developing resources to better support supervised training experiences which instill the competencies required for professional practice.    <\/div><div id=\"field_48_50\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >CPATA is seeking  16 agents (trainees and supervisors) for a Working Group to develop Supervised Practice Resources.  These licensees will attend online meetings and complete surveys in June 2026 with the goal of developing a template Training Plan, Interim Assessment and Summative Evaluation to frame the supervised practice training program. Later this year, CPATA will be seeking bilingual (French\/English) licensees to review the translation of the templates. The resources will then be finalized and become available in 2027 for supervisors and trainees to use for tracking and evaluating competency acquisition. <\/div><div id=\"field_48_51\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Please submit an expression of interest before April 3 to participate. <\/div><div id=\"field_48_53\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h4 class=\"opp-title\">Working Group to Develop Supervised Practice Resources<\/h4>\n\n<table class=\"opp-table\" role=\"table\" aria-label=\"2026 Opportunities\">\n  <thead>\n    <tr>\n      <th>Group<\/th>\n      <th>Seeking<\/th>\n      <th>Purpose<\/th>\n      <th>Tasks and Time Commitment<\/th>\n      <th>Honorarium<\/th>\n    <\/tr>\n  <\/thead>\n\n  <tbody>\n    <tr>\n      <td>\n        Working Group to Develop Supervised Practice Resources\n      <\/td>\n\n      <td>\n       - 4 patent agent trainees<br \/>\n       - 4 trademark agent trainees<br \/>\n       - 4 patent agent supervisors<br \/>\n       - 4 trademark agent supervisors\n      <\/td>\n\n      <td>\n        Develop resources to support the supervised practice training program:\n        <ul class=\"dash-list\">\n          <li>Training Plan<\/li>\n          <li>Interim Assessment<\/li>\n          <li>Summative Evaluation<\/li>\n        <\/ul>\n      <\/td>\n\n      <td>\n        <b>Tasks:<\/b>\n        <ul>\n          <li>- Attend a kick-off meeting<\/li>\n          <li>- Attend 1 focus group meeting<\/li>\n          <li>- Complete 3 surveys<\/li>\n          <li>- Attend 1 final meeting<\/li>\n        <\/ul>\n\n        <p><b>Total time commitment:<\/b>- 6 hours for meetings and 2-4 hours for survey completion.<\/p>\n\n        <p><b>Online Meetings:<\/b><\/p>\n\n        <p><b>Kick-off meeting (for all):<\/b><br \/>\n          June 8, 2026, from 1 pm to 3 pm ET.\n        <\/p>\n\n        <p>One of the following meetings, depending on the group:<\/p>\n        <ul>\n          <li>- June 23, 2026, from 12 pm to 2 pm ET (trademark trainees)<\/li>\n          <li>- June 23, 2026, from 2:30 pm to 4:30 pm ET (patent trainees)<\/li>\n          <li>- June 24, 2026, from 12 pm to 2 pm ET (trademark supervisors)<\/li>\n          <li>- June 24, 2026, from 2:30 pm to 4:30 pm ET (patent supervisors)<\/li>\n        <\/ul>\n\n <p>\n    <b>Final Meeting (for all):<\/b><br \/>\n    June 29, 2026, from 1 pm to 3 pm ET.\n  <\/p>\n<\/td>\n\n      <td>\n        $750\n      <\/td>\n    <\/tr>\n  <\/tbody>\n<\/table>\n\n<style>\n  .opp-title{\n    margin: 0 0 22px 0;\n    font-size: 28px;\n    font-weight: 700;\n    line-height: 1.2;\n  }\n\n  .opp-table{\n    width: 100%;\n    border-collapse: collapse;\n    border: 1px solid #e6e6e6;\n    background: #fff;\n  }\n\n  .opp-table th,\n  .opp-table td{\n    border: 1px solid #e6e6e6;\n    padding: 26px 26px;\n    vertical-align: top; \/* g\u00e9n\u00e9ralement mieux pour des cellules longues *\/\n    font-size: 18px;\n    line-height: 1.65;\n  }\n\n  .opp-table th{\n    font-weight: 700;\n    text-align: left;\n    background: #fff;\n  }\n\n  \/* Dash bullets like in the screenshot *\/\n  .dash-list{\n    list-style: none;\n    margin: 0;\n    padding: 0;\n  }\n  .dash-list li{\n    position: relative;\n    padding-left: 18px;\n    margin: 0 0 18px 0;\n  }\n  .dash-list li:last-child{ margin-bottom: 0; }\n  .dash-list li::before{\n    content: \"\u2013\";\n    position: absolute;\n    left: 0;\n    top: 0;\n  }\n<\/style>\n<\/div><fieldset id=\"field_48_47\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >1.  Please indicate which group you are interested in participating in.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_48_47'><div class='gchoice gchoice_48_47_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.1' type='checkbox'  value='Trademark Agent in Training'  id='choice_48_47_1' tabindex='1'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_47_1' id='label_48_47_1' class='gform-field-label gform-field-label--type-inline'>Trademark Agent in Training<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_47_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.2' type='checkbox'  value='Patent Agent in Training'  id='choice_48_47_2' tabindex='2'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_47_2' id='label_48_47_2' class='gform-field-label gform-field-label--type-inline'>Patent Agent in Training<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_47_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.3' type='checkbox'  value='Trademark Agent Supervisor'  id='choice_48_47_3' tabindex='3'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_47_3' id='label_48_47_3' class='gform-field-label gform-field-label--type-inline'>Trademark Agent Supervisor<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_47_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.4' type='checkbox'  value='Patent Agent Supervisor'  id='choice_48_47_4' tabindex='4'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_47_4' id='label_48_47_4' class='gform-field-label gform-field-label--type-inline'>Patent Agent Supervisor<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_48_4\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p><b>2. If you have any interest, please provide your contact information so that we may follow up with further information and communicate with you about this work. <\/p><\/div><fieldset id=\"field_48_5\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><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_48_5'>\n                            \n                            <span id='input_48_5_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_5.3' id='input_48_5_3' value='' tabindex='6'  aria-required='true'     \/>\n                                                    <label for='input_48_5_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_48_5_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_5.6' id='input_48_5_6' value='' tabindex='8'  aria-required='true'     \/>\n                                                    <label for='input_48_5_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_48_6\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_48_6'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_6' id='input_48_6' type='email' value='' class='large' tabindex='10'   aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_48_33\" class=\"gfield gfield--type-survey gfield--input-type-likert gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' >3. To help us communicate better with you, please select which language(s) you are comfortable communicating in.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_likert'><table aria-label='3. To help us communicate better with you, please select which language(s) you are comfortable communicating in.' class='gsurvey-likert' id='input_48_33'><thead><tr><th id='likert_col_1_48_33' scope='col' role='presentation' class='gsurvey-likert-choice-label'>English<\/th><th id='likert_col_2_48_33' scope='col' role='presentation' class='gsurvey-likert-choice-label'>French<\/th><th id='likert_col_3_48_33' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Both<\/th><\/tr><\/thead><tbody><tr><td data-label='English' class='gsurvey-likert-choice'><input name='input_33' type='radio' value='glikertcol33356600a0'  id='choice_48_33_1'  tabindex='11'  aria-labelledby='likert_col_1_48_33'\/><\/td><td data-label='French' class='gsurvey-likert-choice'><input name='input_33' type='radio' value='glikertcol33908d6b3f'  id='choice_48_33_2'  tabindex='12'  aria-labelledby='likert_col_2_48_33'\/><\/td><td data-label='Both' class='gsurvey-likert-choice'><input name='input_33' type='radio' value='glikertcol3302d6c39e'  id='choice_48_33_3'  tabindex='13'  aria-labelledby='likert_col_3_48_33'\/><\/td><\/tr><\/tbody><\/table><\/div><\/div><div id=\"field_48_13\" class=\"gfield gfield--type-survey gfield--input-type-likert gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >4. We are committed to a bilingual program. Please tell us more about your language proficiency to help us identify appropriate opportunities.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_likert'><table aria-label='4. We are committed to a bilingual program. Please tell us more about your language proficiency to help us identify appropriate opportunities.' class='gsurvey-likert' id='input_48_13'><thead><tr><td scope='col' class='gsurvey-likert-row-label'><\/td><th id='likert_col_1_48_13' scope='col'  class='gsurvey-likert-choice-label'>0 - None (essentially no knowledge)<\/th><th id='likert_col_2_48_13' scope='col'  class='gsurvey-likert-choice-label'>1 - Elementary (simple words and sentences)<\/th><th id='likert_col_3_48_13' scope='col'  class='gsurvey-likert-choice-label'>2 - Limited working (basic commands and phrases)<\/th><th id='likert_col_4_48_13' scope='col'  class='gsurvey-likert-choice-label'>3 - Professional working (contributes comfortably)<\/th><th id='likert_col_5_48_13' scope='col'  class='gsurvey-likert-choice-label'>4 - Full professional (advanced, minor errors)<\/th><th id='likert_col_6_48_13' scope='col'  class='gsurvey-likert-choice-label'>5 - Native or bilingual (complete fluency)<\/th><\/tr><\/thead><tbody><tr><td id='likert_row_1_48_13' data-label='' class='gsurvey-likert-row-label'>English<\/td><td data-label='0 - None (essentially no knowledge)' class='gsurvey-likert-choice'><input name='input_13.1' type='radio' value='glikertrowbb82ca37:glikertcol139bab3fc7'  id='choice_48_13_1_1'  tabindex='14'  aria-labelledby='likert_row_1_48_13 likert_col_1_48_13'\/><\/td><td data-label='1 - Elementary (simple words and sentences)' class='gsurvey-likert-choice'><input name='input_13.1' type='radio' value='glikertrowbb82ca37:glikertcol13cdbdfc64'  id='choice_48_13_1_2'  tabindex='15'  aria-labelledby='likert_row_1_48_13 likert_col_2_48_13'\/><\/td><td data-label='2 - Limited working (basic commands and phrases)' class='gsurvey-likert-choice'><input name='input_13.1' type='radio' value='glikertrowbb82ca37:glikertcol13611b48ae'  id='choice_48_13_1_3'  tabindex='16'  aria-labelledby='likert_row_1_48_13 likert_col_3_48_13'\/><\/td><td data-label='3 - Professional working (contributes comfortably)' class='gsurvey-likert-choice'><input name='input_13.1' type='radio' value='glikertrowbb82ca37:glikertcol1378d6fb69'  id='choice_48_13_1_4'  tabindex='17'  aria-labelledby='likert_row_1_48_13 likert_col_4_48_13'\/><\/td><td data-label='4 - Full professional (advanced, minor errors)' class='gsurvey-likert-choice'><input name='input_13.1' type='radio' value='glikertrowbb82ca37:glikertcol13e82337f7'  id='choice_48_13_1_5'  tabindex='18'  aria-labelledby='likert_row_1_48_13 likert_col_5_48_13'\/><\/td><td data-label='5 - Native or bilingual (complete fluency)' class='gsurvey-likert-choice'><input name='input_13.1' type='radio' value='glikertrowbb82ca37:glikertcol132fc2671c'  id='choice_48_13_1_6'  tabindex='19'  aria-labelledby='likert_row_1_48_13 likert_col_6_48_13'\/><\/td><\/tr><tr><td id='likert_row_2_48_13' data-label='' class='gsurvey-likert-row-label'>French<\/td><td data-label='0 - None (essentially no knowledge)' class='gsurvey-likert-choice'><input name='input_13.2' type='radio' value='glikertrowe086824c:glikertcol139bab3fc7'  id='choice_48_13_2_1'  tabindex='20'  aria-labelledby='likert_row_2_48_13 likert_col_1_48_13'\/><\/td><td data-label='1 - Elementary (simple words and sentences)' class='gsurvey-likert-choice'><input name='input_13.2' type='radio' value='glikertrowe086824c:glikertcol13cdbdfc64'  id='choice_48_13_2_2'  tabindex='21'  aria-labelledby='likert_row_2_48_13 likert_col_2_48_13'\/><\/td><td data-label='2 - Limited working (basic commands and phrases)' class='gsurvey-likert-choice'><input name='input_13.2' type='radio' value='glikertrowe086824c:glikertcol13611b48ae'  id='choice_48_13_2_3'  tabindex='22'  aria-labelledby='likert_row_2_48_13 likert_col_3_48_13'\/><\/td><td data-label='3 - Professional working (contributes comfortably)' class='gsurvey-likert-choice'><input name='input_13.2' type='radio' value='glikertrowe086824c:glikertcol1378d6fb69'  id='choice_48_13_2_4'  tabindex='23'  aria-labelledby='likert_row_2_48_13 likert_col_4_48_13'\/><\/td><td data-label='4 - Full professional (advanced, minor errors)' class='gsurvey-likert-choice'><input name='input_13.2' type='radio' value='glikertrowe086824c:glikertcol13e82337f7'  id='choice_48_13_2_5'  tabindex='24'  aria-labelledby='likert_row_2_48_13 likert_col_5_48_13'\/><\/td><td data-label='5 - Native or bilingual (complete fluency)' class='gsurvey-likert-choice'><input name='input_13.2' type='radio' value='glikertrowe086824c:glikertcol132fc2671c'  id='choice_48_13_2_6'  tabindex='25'  aria-labelledby='likert_row_2_48_13 likert_col_6_48_13'\/><\/td><\/tr><\/tbody><\/table><\/div><\/div><fieldset id=\"field_48_54\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >5.  Do you hold any of the following other professional licences in Canada?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_48_54'><div class='gchoice gchoice_48_54_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.1' type='checkbox'  value='Lawyer'  id='choice_48_54_1' tabindex='26'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_54_1' id='label_48_54_1' class='gform-field-label gform-field-label--type-inline'>Lawyer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_54_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.2' type='checkbox'  value='Engineer'  id='choice_48_54_2' tabindex='27'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_54_2' id='label_48_54_2' class='gform-field-label gform-field-label--type-inline'>Engineer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_54_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.3' type='checkbox'  value='Not applicable'  id='choice_48_54_3' tabindex='28'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_54_3' id='label_48_54_3' class='gform-field-label gform-field-label--type-inline'>Not applicable<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_54_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.4' type='checkbox'  value='Other (please specify)'  id='choice_48_54_4' tabindex='29'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_54_4' id='label_48_54_4' class='gform-field-label gform-field-label--type-inline'>Other (please specify)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_48_55\" class=\"gfield gfield--type-survey gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' for='input_48_55'>Please specify<\/label><div class='ginput_container ginput_container_text'><input name='input_55' id='input_48_55' type='text' value='' class='large'   tabindex='30'   aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_48_16\" class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >6. In which of the following practice areas do you feel you have significant expertise? Please check all that apply.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_48_16'><div class='gchoice gchoice_48_16_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.1' type='checkbox'  value='Aerospace, Aeronautics and Aviation Agricultural Sciences'  id='choice_48_16_1' tabindex='31'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_16_1' id='label_48_16_1' class='gform-field-label gform-field-label--type-inline'>Aerospace and aviation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_16_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.2' type='checkbox'  value='gsurvey1658bb10bc'  id='choice_48_16_2' tabindex='32'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_16_2' id='label_48_16_2' class='gform-field-label gform-field-label--type-inline'>Agriculture<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_16_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.3' type='checkbox'  value='Artificial Intelligence'  id='choice_48_16_3' tabindex='33'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_16_3' id='label_48_16_3' class='gform-field-label gform-field-label--type-inline'>Artificial Intelligence<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_16_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.4' type='checkbox'  value='Automotive'  id='choice_48_16_4' tabindex='34'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_16_4' id='label_48_16_4' class='gform-field-label gform-field-label--type-inline'>Automotive<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_16_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.5' type='checkbox'  value='Cannabis'  id='choice_48_16_5' tabindex='35'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_16_5' id='label_48_16_5' class='gform-field-label gform-field-label--type-inline'>Cannabis<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_16_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.6' type='checkbox'  value='Chemical and Biotechnology'  id='choice_48_16_6' tabindex='36'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_16_6' id='label_48_16_6' class='gform-field-label gform-field-label--type-inline'>Chemical and Biotechnology<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_16_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.7' type='checkbox'  value='Cleantech'  id='choice_48_16_7' tabindex='37'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_16_7' id='label_48_16_7' class='gform-field-label gform-field-label--type-inline'>Cleantech<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_16_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.8' type='checkbox'  value='gsurvey161bd871f3'  id='choice_48_16_8' tabindex='38'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_16_8' id='label_48_16_8' class='gform-field-label gform-field-label--type-inline'>Clothing and Apparel<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_16_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.9' type='checkbox'  value='gsurvey16fd2d3ff6'  id='choice_48_16_9' tabindex='39'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_16_9' id='label_48_16_9' class='gform-field-label gform-field-label--type-inline'>Computers<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_16_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.11' type='checkbox'  value='Consumer Products'  id='choice_48_16_11' tabindex='40'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_16_11' id='label_48_16_11' class='gform-field-label gform-field-label--type-inline'>Consumer Products<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_16_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.12' type='checkbox'  value='gsurvey168a1a0522'  id='choice_48_16_12' tabindex='41'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_16_12' id='label_48_16_12' class='gform-field-label gform-field-label--type-inline'>Cryptocurrency<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_16_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.13' type='checkbox'  value='Electronics and Computer Technology'  id='choice_48_16_13' tabindex='42'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_16_13' id='label_48_16_13' class='gform-field-label gform-field-label--type-inline'>Electronics<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_16_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.14' type='checkbox'  value='Energy Oil and Gas'  id='choice_48_16_14' tabindex='43'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_16_14' id='label_48_16_14' class='gform-field-label gform-field-label--type-inline'>Energy<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_16_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.15' type='checkbox'  value='Financial Services and Technology'  id='choice_48_16_15' tabindex='44'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_16_15' id='label_48_16_15' class='gform-field-label gform-field-label--type-inline'>Financial Services and Technology<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_16_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.16' type='checkbox'  value='Food and Beverage'  id='choice_48_16_16' tabindex='45'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_16_16' id='label_48_16_16' class='gform-field-label gform-field-label--type-inline'>Food and Beverage<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_16_17'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.17' type='checkbox'  value='gsurvey161813fef4'  id='choice_48_16_17' tabindex='46'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_16_17' id='label_48_16_17' class='gform-field-label gform-field-label--type-inline'>Manufacturing<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_16_18'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.18' type='checkbox'  value='Medical Devices'  id='choice_48_16_18' tabindex='47'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_16_18' id='label_48_16_18' class='gform-field-label gform-field-label--type-inline'>Medical Devices<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_16_19'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.19' type='checkbox'  value='gsurvey16f2b4e021'  id='choice_48_16_19' tabindex='48'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_16_19' id='label_48_16_19' class='gform-field-label gform-field-label--type-inline'>Mining<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_16_21'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.21' type='checkbox'  value='Pharmaceuticals and Biologics'  id='choice_48_16_21' tabindex='49'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_16_21' id='label_48_16_21' class='gform-field-label gform-field-label--type-inline'>Pharmaceuticals<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_16_22'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.22' type='checkbox'  value='Railways'  id='choice_48_16_22' tabindex='50'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_16_22' id='label_48_16_22' class='gform-field-label gform-field-label--type-inline'>Railways<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_16_23'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.23' type='checkbox'  value='Robotics'  id='choice_48_16_23' tabindex='51'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_16_23' id='label_48_16_23' class='gform-field-label gform-field-label--type-inline'>Robotics<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_16_24'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.24' type='checkbox'  value='Software, Information &amp; Cloud Technologies'  id='choice_48_16_24' tabindex='52'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_16_24' id='label_48_16_24' class='gform-field-label gform-field-label--type-inline'>Software<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_16_25'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.25' type='checkbox'  value='Telecommunications'  id='choice_48_16_25' tabindex='53'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_16_25' id='label_48_16_25' class='gform-field-label gform-field-label--type-inline'>Telecommunications<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_16_26'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.26' type='checkbox'  value='Other (please specify)'  id='choice_48_16_26' tabindex='54'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_16_26' id='label_48_16_26' class='gform-field-label gform-field-label--type-inline'>Other (please specify)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_48_35\" class=\"gfield gfield--type-survey gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' for='input_48_35'>Please specify<\/label><div class='ginput_container ginput_container_text'><input name='input_35' id='input_48_35' type='text' value='' class='large'   tabindex='55'   aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_48_18\" class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >7. In which of the following skills do you feel you have significant expertise? Please check all that apply.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_48_18'><div class='gchoice gchoice_48_18_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.1' type='checkbox'  value='IP strategy'  id='choice_48_18_1' tabindex='56'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_18_1' id='label_48_18_1' class='gform-field-label gform-field-label--type-inline'>IP strategy<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_18_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.2' type='checkbox'  value='Communication'  id='choice_48_18_2' tabindex='57'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_18_2' id='label_48_18_2' class='gform-field-label gform-field-label--type-inline'>Communication<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_18_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.3' type='checkbox'  value='Working with others'  id='choice_48_18_3' tabindex='58'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_18_3' id='label_48_18_3' class='gform-field-label gform-field-label--type-inline'>Working with others<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_18_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.4' type='checkbox'  value='Client relations'  id='choice_48_18_4' tabindex='59'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_18_4' id='label_48_18_4' class='gform-field-label gform-field-label--type-inline'>Client relations<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_18_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.5' type='checkbox'  value='Workload management'  id='choice_48_18_5' tabindex='60'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_18_5' id='label_48_18_5' class='gform-field-label gform-field-label--type-inline'>Workload management<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_18_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.6' type='checkbox'  value='Business awareness'  id='choice_48_18_6' tabindex='61'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_18_6' id='label_48_18_6' class='gform-field-label gform-field-label--type-inline'>Business awareness<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_18_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.7' type='checkbox'  value='Professional conduct'  id='choice_48_18_7' tabindex='62'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_18_7' id='label_48_18_7' class='gform-field-label gform-field-label--type-inline'>Professional conduct<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_18_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.8' type='checkbox'  value='gsurvey18197ea2b9'  id='choice_48_18_8' tabindex='63'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_18_8' id='label_48_18_8' class='gform-field-label gform-field-label--type-inline'>Drafting applications<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_18_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.9' type='checkbox'  value='gsurvey18a6d4f50e'  id='choice_48_18_9' tabindex='64'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_18_9' id='label_48_18_9' class='gform-field-label gform-field-label--type-inline'>Infringement\/Validity<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_18_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.11' type='checkbox'  value='gsurvey18911d6a20'  id='choice_48_18_11' tabindex='65'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_18_11' id='label_48_18_11' class='gform-field-label gform-field-label--type-inline'>Opposition Proceedings<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_18_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.12' type='checkbox'  value='gsurvey18be0f4d40'  id='choice_48_18_12' tabindex='66'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_18_12' id='label_48_18_12' class='gform-field-label gform-field-label--type-inline'>Prosecution<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_48_20\" class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >8. What best describes your primary practice setting?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_48_20'><div class='gchoice gchoice_48_20_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.1' type='checkbox'  value='As a Sole Practitioner'  id='choice_48_20_1' tabindex='67'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_20_1' id='label_48_20_1' class='gform-field-label gform-field-label--type-inline'>Academic institution<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_20_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.2' type='checkbox'  value='In a Patent or Trademark Agent Firm'  id='choice_48_20_2' tabindex='68'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_20_2' id='label_48_20_2' class='gform-field-label gform-field-label--type-inline'>Government<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_20_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.3' type='checkbox'  value='gsurvey2078e4076f'  id='choice_48_20_3' tabindex='69'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_20_3' id='label_48_20_3' class='gform-field-label gform-field-label--type-inline'>Corporate (in-house)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_20_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.4' type='checkbox'  value='gsurvey2018b12968'  id='choice_48_20_4' tabindex='70'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_20_4' id='label_48_20_4' class='gform-field-label gform-field-label--type-inline'>IP agency<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_20_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.5' type='checkbox'  value='gsurvey20c6405433'  id='choice_48_20_5' tabindex='71'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_20_5' id='label_48_20_5' class='gform-field-label gform-field-label--type-inline'>Law firm<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_20_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.6' type='checkbox'  value='gsurvey20f2ea2c33'  id='choice_48_20_6' tabindex='72'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_20_6' id='label_48_20_6' class='gform-field-label gform-field-label--type-inline'>Sole practitioner<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_20_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.7' type='checkbox'  value='gsurvey20ff01af78'  id='choice_48_20_7' tabindex='73'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_20_7' id='label_48_20_7' class='gform-field-label gform-field-label--type-inline'>Not applicable<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_48_20_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.8' type='checkbox'  value='Other (Please specify'  id='choice_48_20_8' tabindex='74'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_48_20_8' id='label_48_20_8' class='gform-field-label gform-field-label--type-inline'>Other (Please specify)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_48_41\" class=\"gfield gfield--type-survey gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' for='input_48_41'>Please specify<\/label><div class='ginput_container ginput_container_text'><input name='input_41' id='input_48_41' type='text' value='' class='large'   tabindex='75'   aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_48_21\" class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><legend class='gfield_label gform-field-label' >9. Where is your practice primarily located?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_48_21'>\n\t\t\t<div class='gchoice gchoice_48_21_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Alberta'  id='choice_48_21_0' onchange='gformToggleRadioOther( this )'  tabindex='76'  \/>\n\t\t\t\t\t<label for='choice_48_21_0' id='label_48_21_0' class='gform-field-label gform-field-label--type-inline'>Alberta<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_48_21_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='British Columbia'  id='choice_48_21_1' onchange='gformToggleRadioOther( this )'  tabindex='77'  \/>\n\t\t\t\t\t<label for='choice_48_21_1' id='label_48_21_1' class='gform-field-label gform-field-label--type-inline'>British Columbia<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_48_21_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Manitoba'  id='choice_48_21_2' onchange='gformToggleRadioOther( this )'  tabindex='78'  \/>\n\t\t\t\t\t<label for='choice_48_21_2' id='label_48_21_2' class='gform-field-label gform-field-label--type-inline'>Manitoba<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_48_21_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='New Brunswick'  id='choice_48_21_3' onchange='gformToggleRadioOther( this )'  tabindex='79'  \/>\n\t\t\t\t\t<label for='choice_48_21_3' id='label_48_21_3' class='gform-field-label gform-field-label--type-inline'>New Brunswick<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_48_21_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Newfoundland and Labrador'  id='choice_48_21_4' onchange='gformToggleRadioOther( this )'  tabindex='80'  \/>\n\t\t\t\t\t<label for='choice_48_21_4' id='label_48_21_4' class='gform-field-label gform-field-label--type-inline'>Newfoundland and Labrador<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_48_21_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Northwest Territories'  id='choice_48_21_5' onchange='gformToggleRadioOther( this )'  tabindex='81'  \/>\n\t\t\t\t\t<label for='choice_48_21_5' id='label_48_21_5' class='gform-field-label gform-field-label--type-inline'>Northwest Territories<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_48_21_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Nova Scotia'  id='choice_48_21_6' onchange='gformToggleRadioOther( this )'  tabindex='82'  \/>\n\t\t\t\t\t<label for='choice_48_21_6' id='label_48_21_6' class='gform-field-label gform-field-label--type-inline'>Nova Scotia<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_48_21_7'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Nunavut'  id='choice_48_21_7' onchange='gformToggleRadioOther( this )'  tabindex='83'  \/>\n\t\t\t\t\t<label for='choice_48_21_7' id='label_48_21_7' class='gform-field-label gform-field-label--type-inline'>Nunavut<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_48_21_8'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Ontario'  id='choice_48_21_8' onchange='gformToggleRadioOther( this )'  tabindex='84'  \/>\n\t\t\t\t\t<label for='choice_48_21_8' id='label_48_21_8' class='gform-field-label gform-field-label--type-inline'>Ontario<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_48_21_9'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Prince Edward Island'  id='choice_48_21_9' onchange='gformToggleRadioOther( this )'  tabindex='85'  \/>\n\t\t\t\t\t<label for='choice_48_21_9' id='label_48_21_9' class='gform-field-label gform-field-label--type-inline'>Prince Edward Island<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_48_21_10'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Quebec'  id='choice_48_21_10' onchange='gformToggleRadioOther( this )'  tabindex='86'  \/>\n\t\t\t\t\t<label for='choice_48_21_10' id='label_48_21_10' class='gform-field-label gform-field-label--type-inline'>Quebec<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_48_21_11'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Saskatchewan'  id='choice_48_21_11' onchange='gformToggleRadioOther( this )'  tabindex='87'  \/>\n\t\t\t\t\t<label for='choice_48_21_11' id='label_48_21_11' class='gform-field-label gform-field-label--type-inline'>Saskatchewan<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_48_21_12'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Yukon'  id='choice_48_21_12' onchange='gformToggleRadioOther( this )'  tabindex='88'  \/>\n\t\t\t\t\t<label for='choice_48_21_12' id='label_48_21_12' class='gform-field-label gform-field-label--type-inline'>Yukon<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_48_21_13'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='gsurvey214af8b475'  id='choice_48_21_13' onchange='gformToggleRadioOther( this )'  tabindex='89'  \/>\n\t\t\t\t\t<label for='choice_48_21_13' id='label_48_21_13' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_48_34\" class=\"gfield gfield--type-survey gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' for='input_48_34'>Please specify<\/label><div class='ginput_container ginput_container_text'><input name='input_34' id='input_48_34' type='text' value='' class='large'   tabindex='90'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_48_22\" class=\"gfield gfield--type-survey gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' for='input_48_22'>10. In what year were you initially licensed?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_22' id='input_48_22' class='large gfield_select' tabindex='91'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select Year<\/option><option value='gsurvey2203c170f2' >2026<\/option><option value='gsurvey22f7c36a16' >2025<\/option><option value='gsurvey22c99d3187' >2024<\/option><option value='gsurvey228d4a5484' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><\/select><\/div><\/div><fieldset id=\"field_48_24\" class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><legend class='gfield_label gform-field-label' >11. How would you describe your gender?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_48_24'>\n\t\t\t<div class='gchoice gchoice_48_24_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='gsurvey24fdf3fa12'  id='choice_48_24_0' onchange='gformToggleRadioOther( this )'  tabindex='92'  \/>\n\t\t\t\t\t<label for='choice_48_24_0' id='label_48_24_0' class='gform-field-label gform-field-label--type-inline'>Female<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_48_24_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='gsurvey244682bfe4'  id='choice_48_24_1' onchange='gformToggleRadioOther( this )'  tabindex='93'  \/>\n\t\t\t\t\t<label for='choice_48_24_1' id='label_48_24_1' class='gform-field-label gform-field-label--type-inline'>Male<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_48_24_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='gsurvey2467cbef4a'  id='choice_48_24_2' onchange='gformToggleRadioOther( this )'  tabindex='94'  \/>\n\t\t\t\t\t<label for='choice_48_24_2' id='label_48_24_2' class='gform-field-label gform-field-label--type-inline'>Nonbinary<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_48_24_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='gsurvey24f19fe5a1'  id='choice_48_24_3' onchange='gformToggleRadioOther( this )'  tabindex='95'  \/>\n\t\t\t\t\t<label for='choice_48_24_3' id='label_48_24_3' class='gform-field-label gform-field-label--type-inline'>Prefer not to say<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_48_24_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='gsurvey243a262d32'  id='choice_48_24_4' onchange='gformToggleRadioOther( this )'  tabindex='96'  \/>\n\t\t\t\t\t<label for='choice_48_24_4' id='label_48_24_4' class='gform-field-label gform-field-label--type-inline'>Prefer to self describe:<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_48_36\" class=\"gfield gfield--type-survey gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' for='input_48_36'>Description<\/label><div class='ginput_container ginput_container_text'><input name='input_36' id='input_48_36' type='text' value='' class='large'   tabindex='97'   aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_48_26\" class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><legend class='gfield_label gform-field-label' >12. When were you born?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_48_26'>\n\t\t\t<div class='gchoice gchoice_48_26_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='Traditionalist (born 1945 and earlier)'  id='choice_48_26_0' onchange='gformToggleRadioOther( this )'  tabindex='98'  \/>\n\t\t\t\t\t<label for='choice_48_26_0' id='label_48_26_0' class='gform-field-label gform-field-label--type-inline'>1945 or earlier<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_48_26_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='Baby Boomers (born 1946 to 1960)'  id='choice_48_26_1' onchange='gformToggleRadioOther( this )'  tabindex='99'  \/>\n\t\t\t\t\t<label for='choice_48_26_1' id='label_48_26_1' class='gform-field-label gform-field-label--type-inline'>1946 to 1960<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_48_26_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='Generation X (born 1961 to 1980)'  id='choice_48_26_2' onchange='gformToggleRadioOther( this )'  tabindex='100'  \/>\n\t\t\t\t\t<label for='choice_48_26_2' id='label_48_26_2' class='gform-field-label gform-field-label--type-inline'>1961 to 1980<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_48_26_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='Millennial or Gen Y (born 1981 to 1995)'  id='choice_48_26_3' onchange='gformToggleRadioOther( this )'  tabindex='101'  \/>\n\t\t\t\t\t<label for='choice_48_26_3' id='label_48_26_3' class='gform-field-label gform-field-label--type-inline'>1981 to 1995<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_48_26_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='Gen Z (born 1995 to 2010)'  id='choice_48_26_4' onchange='gformToggleRadioOther( this )'  tabindex='102'  \/>\n\t\t\t\t\t<label for='choice_48_26_4' id='label_48_26_4' class='gform-field-label gform-field-label--type-inline'>1996 or later<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_48_26_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='Prefer not to say'  id='choice_48_26_5' onchange='gformToggleRadioOther( this )'  tabindex='103'  \/>\n\t\t\t\t\t<label for='choice_48_26_5' id='label_48_26_5' class='gform-field-label gform-field-label--type-inline'>I prefer not to answer<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_48_27\" class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><legend class='gfield_label gform-field-label' >13. We are committed to having diversity across the pool of subject matter experts.  Other than for reasons of gender, generation, or language, are you a member of a group that is, or may be, underrepresented in agent practice? (e.g., racialized identity, sexual orientation, disability, socioeconomics, work or educational background, family status, other cultural factors)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_48_27'>\n\t\t\t<div class='gchoice gchoice_48_27_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='gsurvey276452ee8d'  id='choice_48_27_0' onchange='gformToggleRadioOther( this )'  tabindex='104'  \/>\n\t\t\t\t\t<label for='choice_48_27_0' id='label_48_27_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_48_27_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='gsurvey272fedd565'  id='choice_48_27_1' onchange='gformToggleRadioOther( this )'  tabindex='105'  \/>\n\t\t\t\t\t<label for='choice_48_27_1' id='label_48_27_1' class='gform-field-label gform-field-label--type-inline'>Yes (please share)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_48_37\" class=\"gfield gfield--type-survey gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' for='input_48_37'>More information<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_37' id='input_48_37' class='textarea medium' tabindex='106'     aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_48_29\" class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><legend class='gfield_label gform-field-label' >14. Have you volunteered for similar competency initiatives in the past?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_48_29'>\n\t\t\t<div class='gchoice gchoice_48_29_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='gsurvey29adac0d6a'  id='choice_48_29_0' onchange='gformToggleRadioOther( this )'  tabindex='107'  \/>\n\t\t\t\t\t<label for='choice_48_29_0' id='label_48_29_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_48_29_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='gsurvey29ff10a6b8'  id='choice_48_29_1' onchange='gformToggleRadioOther( this )'  tabindex='108'  \/>\n\t\t\t\t\t<label for='choice_48_29_1' id='label_48_29_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_48_38\" class=\"gfield gfield--type-survey gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' for='input_48_38'>Please specify in what capacity:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_38' id='input_48_38' class='textarea medium' tabindex='109'     aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_48_31\" class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><legend class='gfield_label gform-field-label' >15. Do you have any other comments, questions, or concerns?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_48_31'>\n\t\t\t<div class='gchoice gchoice_48_31_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='gsurvey31d68d2e66'  id='choice_48_31_0' onchange='gformToggleRadioOther( this )'  tabindex='110'  \/>\n\t\t\t\t\t<label for='choice_48_31_0' id='label_48_31_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_48_31_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='gsurvey3191a600a8'  id='choice_48_31_1' onchange='gformToggleRadioOther( this )'  tabindex='111'  \/>\n\t\t\t\t\t<label for='choice_48_31_1' id='label_48_31_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_48_48\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_48_48'>More information<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_48' id='input_48_48' class='textarea medium' tabindex='112'   placeholder='More information'  aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_48_46\" class=\"gfield gfield--type-captcha gfield--input-type-captcha gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_48_46'>CAPTCHA<\/label><div id='input_48_46' class='ginput_container 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