{"id":9842,"date":"2024-02-13T14:56:02","date_gmt":"2024-02-13T20:56:02","guid":{"rendered":"https:\/\/web.saumag.edu\/career-services\/?page_id=9842"},"modified":"2024-02-13T14:56:02","modified_gmt":"2024-02-13T20:56:02","slug":"career-closet-daily-log","status":"publish","type":"page","link":"https:\/\/www.saumag.edu\/career-services\/career-closet-daily-log\/","title":{"rendered":"Career Closet Daily Log"},"content":{"rendered":"<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 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var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style><form method='post' enctype='multipart\/form-data'  id='gform_43'  action='\/career-services\/wp-json\/wp\/v2\/pages\/9842' data-formid='43' novalidate><div class='gf_invisible ginput_recaptchav3'  data-tabindex='0'><input id=\"input_5de5aaa6b8b4e04d673db0b116b98541\" class=\"gfield_recaptcha_response\" type=\"hidden\" name=\"input_5de5aaa6b8b4e04d673db0b116b98541\" value=\"\"\/><\/div>\n                        <div class='gform-body gform_body'><div id='gform_fields_43' class='gform_fields top_label form_sublabel_below description_below validation_below' data-column-layout='fill'><div id=\"field_43_3\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"c195295b\" data-field-span=\"12\"><label id='gfield_label_43_3' class='gfield_label gform-field-label' for='input_43_3'><span class='gform-field-label__text'>Date<\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='mm\/dd\/yyyy'\n\t\t\t\t\tid='input_43_3'\n\t\t\t\t\tclass='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_3'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\t\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_43_3' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_43_3' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_43_3' aria-label='Date: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/div><fieldset id=\"field_43_1\" 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=\"e59ac6fa\" data-field-span=\"12\"><legend id='gfield_label_43_1' 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_43_1'>\n                            \n                            <span id='input_43_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_43_1_3' value=''   aria-required='true'     aria-labelledby=\"input_43_1_3_label gfield_label_43_1\"\/>\n                                                    <label for='input_43_1_3' id='input_43_1_3_label' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_43_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_43_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_43_1_6' id='input_43_1_6_label' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_43_4\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"23027896\" data-field-span=\"12\"><label id='gfield_label_43_4' class='gfield_label gform-field-label' for='input_43_4'><span class='gform-field-label__text'>Student ID<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_4' id='input_43_4' type='number' step='any'   value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_43_10\" 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=\"b4dbc100\" data-field-span=\"12\"><label id='gfield_label_43_10' class='gfield_label gform-field-label' for='input_43_10'><span class='gform-field-label__text'>SAU 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_10' id='input_43_10' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_43_8\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"015ffed7\" data-field-span=\"12\"><legend id='gfield_label_43_8' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>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_43_8'>\n\t\t\t<div class='gchoice gchoice_43_8_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='Male'  id='choice_43_8_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_43_8_0 gfield_label_43_8\"   \/>\n\t\t\t\t\t<label for='choice_43_8_0' id='label_43_8_0' class='gform-field-label gform-field-label--type-inline'>Male<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_43_8_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='Female'  id='choice_43_8_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_43_8_1' id='label_43_8_1' class='gform-field-label gform-field-label--type-inline'>Female<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_43_8_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='Prefer not to answer'  id='choice_43_8_2' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_43_8_2' id='label_43_8_2' class='gform-field-label gform-field-label--type-inline'>Prefer not to answer<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_43_9\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"e09341ac\" data-field-span=\"12\"><label id='gfield_label_43_9' class='gfield_label gform-field-label' for='input_43_9'><span class='gform-field-label__text'>Classification?<\/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_9' id='input_43_9' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Freshman' >Freshman<\/option><option value='Sophomore' >Sophomore<\/option><option value='Junior' >Junior<\/option><option value='Senior' >Senior<\/option><option value='Graduate' >Graduate<\/option><option value='Alumni' >Alumni<\/option><\/select><\/div><\/div><fieldset id=\"field_43_5\" 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=\"d4049338\" data-field-span=\"12\"><legend id='gfield_label_43_5' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Click all items that were picked up<\/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_43_5'><div class='gchoice gchoice_43_5_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.1' type='checkbox'  value='Women Shirt'  id='choice_43_5_1'    aria-labelledby=\"label_43_5_1 gfield_label_43_5\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_43_5_1' id='label_43_5_1' class='gform-field-label gform-field-label--type-inline'>Women Shirt<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_5_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.2' type='checkbox'  value='Men Shirt'  id='choice_43_5_2'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_5_2' id='label_43_5_2' class='gform-field-label gform-field-label--type-inline'>Men Shirt<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_5_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.3' type='checkbox'  value='Women Skirt\/Slacks'  id='choice_43_5_3'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_5_3' id='label_43_5_3' class='gform-field-label gform-field-label--type-inline'>Women Skirt\/Slacks<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_5_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.4' type='checkbox'  value='Men Slacks'  id='choice_43_5_4'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_5_4' id='label_43_5_4' class='gform-field-label gform-field-label--type-inline'>Men Slacks<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_5_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.5' type='checkbox'  value='Women Blazer'  id='choice_43_5_5'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_5_5' id='label_43_5_5' class='gform-field-label gform-field-label--type-inline'>Women Blazer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_5_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.6' type='checkbox'  value='Men Blazer'  id='choice_43_5_6'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_5_6' id='label_43_5_6' class='gform-field-label gform-field-label--type-inline'>Men Blazer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_5_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.7' type='checkbox'  value='Women Dress'  id='choice_43_5_7'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_5_7' id='label_43_5_7' class='gform-field-label gform-field-label--type-inline'>Women Dress<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_5_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.8' type='checkbox'  value='Women Shoes'  id='choice_43_5_8'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_5_8' id='label_43_5_8' class='gform-field-label gform-field-label--type-inline'>Women Shoes<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_5_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.9' type='checkbox'  value='Men Shoes'  id='choice_43_5_9'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_5_9' id='label_43_5_9' class='gform-field-label gform-field-label--type-inline'>Men Shoes<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_5_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.11' type='checkbox'  value='Tank Top\/Camisole'  id='choice_43_5_11'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_5_11' id='label_43_5_11' class='gform-field-label gform-field-label--type-inline'>Tank Top\/Camisole<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_5_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.12' type='checkbox'  value='Tie\/Bowtie'  id='choice_43_5_12'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_5_12' id='label_43_5_12' class='gform-field-label gform-field-label--type-inline'>Tie\/Bowtie<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_5_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.13' type='checkbox'  value='Tie Clip'  id='choice_43_5_13'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_5_13' id='label_43_5_13' class='gform-field-label gform-field-label--type-inline'>Tie Clip<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_5_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.14' type='checkbox'  value='Socks'  id='choice_43_5_14'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_5_14' id='label_43_5_14' class='gform-field-label gform-field-label--type-inline'>Socks<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_5_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.15' type='checkbox'  value='Cuff Links'  id='choice_43_5_15'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_5_15' id='label_43_5_15' class='gform-field-label gform-field-label--type-inline'>Cuff Links<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_5_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.16' type='checkbox'  value='Belt'  id='choice_43_5_16'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_5_16' id='label_43_5_16' class='gform-field-label gform-field-label--type-inline'>Belt<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_43_7\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"2b49510a\" data-field-span=\"12\"><legend id='gfield_label_43_7' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Click all items that were picked up (If two of same item were picked up.)<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_43_7'><div class='gchoice gchoice_43_7_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.1' type='checkbox'  value='Women Shirt'  id='choice_43_7_1'    aria-labelledby=\"label_43_7_1 gfield_label_43_7\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_43_7_1' id='label_43_7_1' class='gform-field-label gform-field-label--type-inline'>Women Shirt<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_7_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.2' type='checkbox'  value='Men Shirt'  id='choice_43_7_2'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_7_2' id='label_43_7_2' class='gform-field-label gform-field-label--type-inline'>Men Shirt<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_7_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.3' type='checkbox'  value='Women Skirt\/Slacks'  id='choice_43_7_3'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_7_3' id='label_43_7_3' class='gform-field-label gform-field-label--type-inline'>Women Skirt\/Slacks<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_7_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.4' type='checkbox'  value='Men Slacks'  id='choice_43_7_4'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_7_4' id='label_43_7_4' class='gform-field-label gform-field-label--type-inline'>Men Slacks<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_7_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.5' type='checkbox'  value='Women Blazer'  id='choice_43_7_5'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_7_5' id='label_43_7_5' class='gform-field-label gform-field-label--type-inline'>Women Blazer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_7_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.6' type='checkbox'  value='Men Blazer'  id='choice_43_7_6'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_7_6' id='label_43_7_6' class='gform-field-label gform-field-label--type-inline'>Men Blazer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_7_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.7' type='checkbox'  value='Women Dress'  id='choice_43_7_7'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_7_7' id='label_43_7_7' class='gform-field-label gform-field-label--type-inline'>Women Dress<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_7_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.8' type='checkbox'  value='Women Shoes'  id='choice_43_7_8'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_7_8' id='label_43_7_8' class='gform-field-label gform-field-label--type-inline'>Women Shoes<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_7_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.9' type='checkbox'  value='Men Shoes'  id='choice_43_7_9'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_7_9' id='label_43_7_9' class='gform-field-label gform-field-label--type-inline'>Men Shoes<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_7_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.11' type='checkbox'  value='Tank Top\/Camisole'  id='choice_43_7_11'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_7_11' id='label_43_7_11' class='gform-field-label gform-field-label--type-inline'>Tank Top\/Camisole<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_7_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.12' type='checkbox'  value='Tie\/Bowtie'  id='choice_43_7_12'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_7_12' id='label_43_7_12' class='gform-field-label gform-field-label--type-inline'>Tie\/Bowtie<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_7_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.13' type='checkbox'  value='Tie Clip'  id='choice_43_7_13'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_7_13' id='label_43_7_13' class='gform-field-label gform-field-label--type-inline'>Tie Clip<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_7_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.14' type='checkbox'  value='Socks'  id='choice_43_7_14'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_7_14' id='label_43_7_14' class='gform-field-label gform-field-label--type-inline'>Socks<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_7_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.15' type='checkbox'  value='Cuff Links'  id='choice_43_7_15'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_7_15' id='label_43_7_15' class='gform-field-label gform-field-label--type-inline'>Cuff Links<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_43_7_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.16' type='checkbox'  value='Belt'  id='choice_43_7_16'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_43_7_16' id='label_43_7_16' class='gform-field-label gform-field-label--type-inline'>Belt<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_43_6\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"1ef72db7\" data-field-span=\"12\"><label id='gfield_label_43_6' class='gfield_label gform-field-label' for='input_43_6'><span class='gform-field-label__text'>Notes<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_43_6' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <button type='submit' id='gform_submit_button_43' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Submit<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_43' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_43' id='gform_theme_43' value='orbital' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_43' id='gform_style_settings_43' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_43' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='43' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='l1HPnHF9Y7uIlJUsgOaHngmlZimAM2hkiDiydIeOSojcGbXY1Rlrler+wqmjssnd0GWhnZk\/wumSMn6JS+IN\/i4XFk4j7qeMy5Ov+C7NBjp0B5o=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_43' 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