{"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' data-column-layout='fill'><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 id='gfield_label_48_56' class='gfield_label gform-field-label' for='input_48_56'><span class='gform-field-label__text'>Company<\/span><\/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><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 gfield--choice-align-vertical\" data-group-id=\"1b632d3e\" data-field-span=\"12\"><legend id='gfield_label_48_47' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>1.  Please indicate which group you are interested in participating in.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_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  \u2013 Bilingual Review'  id='choice_48_47_1' tabindex='1'   aria-labelledby=\"label_48_47_1 gfield_label_48_47\"\/>\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  \u2013 Bilingual Review<\/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 \u2013 Bilingual Review'  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 \u2013 Bilingual Review<\/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\" data-group-id=\"99dcdb2e\" data-field-span=\"12\"><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\" data-group-id=\"193488f8\" data-field-span=\"12\"><legend id='gfield_label_48_5' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Name<\/span><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='4'  aria-required='true'     aria-labelledby=\"input_48_5_3_label gfield_label_48_5\"\/>\n                                                    <label for='input_48_5_3' id='input_48_5_3_label' 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='6'  aria-required='true'     \/>\n                                                    <label for='input_48_5_6' id='input_48_5_6_label' 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\" data-group-id=\"1fa8c66e\" data-field-span=\"12\"><label id='gfield_label_48_6' class='gfield_label gform-field-label' for='input_48_6'><span class='gform-field-label__text'>Email<\/span><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='8'   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\" data-group-id=\"54fe60dd\" data-field-span=\"12\"><label id='gfield_label_48_33' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>3. To help us communicate better with you, please select which language(s) you are comfortable communicating in.<\/span><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='9'  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='10'  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='11'  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\" data-group-id=\"e5382037\" data-field-span=\"12\"><label id='gfield_label_48_13' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>4. We are committed to a bilingual program. Please tell us more about your language proficiency to help us identify appropriate opportunities.<\/span><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='12'  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='13'  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='14'  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='15'  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='16'  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='17'  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='18'  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='19'  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='20'  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='21'  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='22'  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='23'  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 gfield--choice-align-vertical\" data-group-id=\"9d3f08ed\" data-field-span=\"12\"><legend id='gfield_label_48_54' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>5.  Do you hold any of the following other professional licences in Canada?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_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='24'   aria-labelledby=\"label_48_54_1 gfield_label_48_54\"\/>\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='25'   \/>\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='26'   \/>\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='27'   \/>\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\" data-group-id=\"e0869463\" data-field-span=\"12\"><label id='gfield_label_48_55' class='gfield_label gform-field-label' for='input_48_55'><span class='gform-field-label__text'>Please specify<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_55' id='input_48_55' type='text' value='' class='large'   tabindex='28'   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 gfield--choice-align-vertical gsurvey-survey-field \" data-field-class=\"gsurvey-survey-field\" data-group-id=\"e3450cc7\" data-field-span=\"12\"><legend id='gfield_label_48_16' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>6. In which of the following practice areas do you feel you have significant expertise? Please check all that apply.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_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='29'   aria-labelledby=\"label_48_16_1 gfield_label_48_16\"\/>\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='30'   \/>\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='31'   \/>\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='32'   \/>\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='33'   \/>\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='34'   \/>\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='35'   \/>\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='36'   \/>\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='37'   \/>\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='38'   \/>\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='39'   \/>\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='40'   \/>\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='41'   \/>\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='42'   \/>\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='43'   \/>\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='44'   \/>\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='45'   \/>\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='46'   \/>\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='47'   \/>\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='48'   \/>\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='49'   \/>\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='50'   \/>\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='51'   \/>\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='52'   \/>\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\" data-group-id=\"8bef1920\" data-field-span=\"12\"><label id='gfield_label_48_35' class='gfield_label gform-field-label' for='input_48_35'><span class='gform-field-label__text'>Please specify<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_35' id='input_48_35' type='text' value='' class='large'   tabindex='53'   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 gfield--choice-align-vertical gsurvey-survey-field \" data-field-class=\"gsurvey-survey-field\" data-group-id=\"c83a0688\" data-field-span=\"12\"><legend id='gfield_label_48_18' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>7. In which of the following skills do you feel you have significant expertise? Please check all that apply.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_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='54'   aria-labelledby=\"label_48_18_1 gfield_label_48_18\"\/>\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='55'   \/>\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='56'   \/>\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='57'   \/>\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='58'   \/>\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='59'   \/>\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='60'   \/>\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='61'   \/>\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='62'   \/>\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='63'   \/>\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='64'   \/>\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 gfield--choice-align-vertical gsurvey-survey-field \" data-field-class=\"gsurvey-survey-field\" data-group-id=\"e9acced1\" data-field-span=\"12\"><legend id='gfield_label_48_20' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>8. What best describes your primary practice setting?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_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='65'   aria-labelledby=\"label_48_20_1 gfield_label_48_20\"\/>\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='66'   \/>\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='67'   \/>\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='68'   \/>\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='69'   \/>\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='70'   \/>\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='71'   \/>\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='72'   \/>\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\" data-group-id=\"80eb4fe2\" data-field-span=\"12\"><label id='gfield_label_48_41' class='gfield_label gform-field-label' for='input_48_41'><span class='gform-field-label__text'>Please specify<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_41' id='input_48_41' type='text' value='' class='large'   tabindex='73'   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 gfield--choice-align-vertical gsurvey-survey-field \" data-field-class=\"gsurvey-survey-field\" data-group-id=\"50489233\" data-field-span=\"12\"><legend id='gfield_label_48_21' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>9. Where is your practice primarily located?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_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 )'  aria-labelledby=\"label_48_21_0 gfield_label_48_21\" tabindex='74'  \/>\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='75'  \/>\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='76'  \/>\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='77'  \/>\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='78'  \/>\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='79'  \/>\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='80'  \/>\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='81'  \/>\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='82'  \/>\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='83'  \/>\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='84'  \/>\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='85'  \/>\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='86'  \/>\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='87'  \/>\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\" data-group-id=\"b9a2ce9f\" data-field-span=\"12\"><label id='gfield_label_48_34' class='gfield_label gform-field-label' for='input_48_34'><span class='gform-field-label__text'>Please specify<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_34' id='input_48_34' type='text' value='' class='large'   tabindex='88'   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\" data-group-id=\"d542af5b\" data-field-span=\"12\"><label id='gfield_label_48_22' class='gfield_label gform-field-label' for='input_48_22'><span class='gform-field-label__text'>10. In what year were you initially licensed?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_22' id='input_48_22' class='large gfield_select' tabindex='89'   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 gfield--choice-align-vertical gsurvey-survey-field \" data-field-class=\"gsurvey-survey-field\" data-group-id=\"c053b8f3\" data-field-span=\"12\"><legend id='gfield_label_48_24' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>11. How would you describe your gender?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_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 )'  aria-labelledby=\"label_48_24_0 gfield_label_48_24\" tabindex='90'  \/>\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='91'  \/>\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='92'  \/>\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='93'  \/>\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='94'  \/>\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\" data-group-id=\"d7d3bf27\" data-field-span=\"12\"><label id='gfield_label_48_36' class='gfield_label gform-field-label' for='input_48_36'><span class='gform-field-label__text'>Description<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_36' id='input_48_36' type='text' value='' class='large'   tabindex='95'   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 gfield--choice-align-vertical gsurvey-survey-field \" data-field-class=\"gsurvey-survey-field\" data-group-id=\"a1aa1bbf\" data-field-span=\"12\"><legend id='gfield_label_48_26' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>12. When were you born?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_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 )'  aria-labelledby=\"label_48_26_0 gfield_label_48_26\" tabindex='96'  \/>\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='97'  \/>\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='98'  \/>\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='99'  \/>\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='100'  \/>\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='101'  \/>\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 gfield--choice-align-vertical gsurvey-survey-field \" data-field-class=\"gsurvey-survey-field\" data-group-id=\"a19c0c72\" data-field-span=\"12\"><legend id='gfield_label_48_27' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>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><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 )'  aria-labelledby=\"label_48_27_0 gfield_label_48_27\" tabindex='102'  \/>\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='103'  \/>\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\" data-group-id=\"44a6b04e\" data-field-span=\"12\"><label id='gfield_label_48_37' class='gfield_label gform-field-label' for='input_48_37'><span class='gform-field-label__text'>More information<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_37' id='input_48_37' class='textarea medium' tabindex='104'     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 gfield--choice-align-vertical gsurvey-survey-field \" data-field-class=\"gsurvey-survey-field\" data-group-id=\"edf75220\" data-field-span=\"12\"><legend id='gfield_label_48_29' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>14. Have you volunteered for similar competency initiatives in the past?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_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 )'  aria-labelledby=\"label_48_29_0 gfield_label_48_29\" tabindex='105'  \/>\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='106'  \/>\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\" data-group-id=\"a93652c0\" data-field-span=\"12\"><label id='gfield_label_48_38' class='gfield_label gform-field-label' for='input_48_38'><span class='gform-field-label__text'>Please specify in what capacity:<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_38' id='input_48_38' class='textarea medium' tabindex='107'     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 gfield--choice-align-vertical gsurvey-survey-field \" data-field-class=\"gsurvey-survey-field\" data-group-id=\"3d860d52\" data-field-span=\"12\"><legend id='gfield_label_48_31' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>15. Do you have any other comments, questions, or concerns?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_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 )'  aria-labelledby=\"label_48_31_0 gfield_label_48_31\" tabindex='108'  \/>\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='109'  \/>\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\" data-group-id=\"672fccba\" data-field-span=\"12\"><label id='gfield_label_48_48' class='gfield_label gform-field-label' for='input_48_48'><span class='gform-field-label__text'>More information<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_48' id='input_48_48' class='textarea medium' tabindex='110'   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 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