{"id":6905,"date":"2021-01-18T15:50:39","date_gmt":"2021-01-18T23:50:39","guid":{"rendered":"https:\/\/tillamookhabitat.org\/?page_id=6905"},"modified":"2021-01-18T15:50:39","modified_gmt":"2021-01-18T23:50:39","slug":"full-client-application-form","status":"publish","type":"page","link":"https:\/\/tillamookhabitat.org\/full-client-application-form\/","title":{"rendered":"Full Client Application Form"},"content":{"rendered":"<script type=\"text\/javascript\">if(!gform){document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0});var gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),null==t&&(t=10),gform.hooks[o][n].push({tag:i,callable:r,priority:t})},doHook:function(o,n,r){if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[o][n]){var t,i=gform.hooks[o][n];i.sort(function(o,n){return o.priority-n.priority});for(var e=0;e<i.length;e++)\"function\"!=typeof(t=i[e].callable)&&(t=window[t]),\"action\"==o?t.apply(null,r):r[0]=t.apply(null,r)}if(\"filter\"==o)return r[0]},removeHook:function(o,n,r,t){if(null!=gform.hooks[o][n])for(var i=gform.hooks[o][n],e=i.length-1;0<=e;e--)null!=t&&t!=i[e].tag||null!=r&&r!=i[e].priority||i.splice(e,1)}}}<\/script>\n                <div class='gf_browser_safari gform_wrapper gform_legacy_markup_wrapper' id='gform_wrapper_35' style='display:none'><div id='gf_35' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n                            <h3 class=\"gform_title\">Full Client Application Form<\/h3>\n                            <span class='gform_description'><\/span>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_35'  action='\/wp-json\/wp\/v2\/pages\/6905#gf_35' novalidate>\n        <div id='gf_progressbar_wrapper_35' class='gf_progressbar_wrapper'>\n        \t<h3 class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>8<\/span>\n        \t<\/h3>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_12' style='width:12%;'><span>12%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform_body gform-body'><div id='gform_page_35_1' class='gform_page' >\n                                    <div class='gform_page_fields'><ul id='gform_fields_35' class='gform_fields top_label form_sublabel_above description_above'><li id=\"field_35_1\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label gfield_label_before_complex'  >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_35_1'>\n                            \n                            <span id='input_35_1_3_container' class='name_first' >\n                                                    <label for='input_35_1_3' >First<\/label>\n                                                    <input type='text' name='input_1.3' id='input_35_1_3' value='' aria-label='First name'   aria-required='true'     \/>\n                                                <\/span>\n                            \n                            <span id='input_35_1_6_container' class='name_last' >\n                                                            <label for='input_35_1_6' >Last<\/label>\n                                                            <input type='text' name='input_1.6' id='input_35_1_6' value='' aria-label='Last name'   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/li><li id=\"field_35_2\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label gfield_label_before_complex'  >Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address' id='input_35_2' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1' id='input_35_2_1_container' >\n                                        <label for='input_35_2_1' id='input_35_2_1_label' >Street Address<\/label>\n                                        <input type='text' name='input_2.1' id='input_35_2_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2' id='input_35_2_2_container' >\n                                        <label for='input_35_2_2' id='input_35_2_2_label' >Address Line 2<\/label>\n                                        <input type='text' name='input_2.2' id='input_35_2_2' value=''     aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city' id='input_35_2_3_container' >\n                                    <label for='input_35_2_3' id='input_35_2_3_label' >City<\/label>\n                                    <input type='text' name='input_2.3' id='input_35_2_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state' id='input_35_2_4_container' >\n                                        <label for='input_35_2_4' id='input_35_2_4_label' >State<\/label>\n                                        <select name='input_2.4' id='input_35_2_4'     aria-required='true'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' selected='selected'>Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip' id='input_35_2_5_container' >\n                                    <label for='input_35_2_5' id='input_35_2_5_label' >ZIP Code<\/label>\n                                    <input type='text' name='input_2.5' id='input_35_2_5' value=''    aria-required='true'   \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_2.6' id='input_35_2_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_35_3\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_3' >Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_35_3' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_4\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_4' >Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_4' id='input_35_4' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_35_5\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_5' >Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_5' id='input_35_5' type='text' value='' class='datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_35_5_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_35_5_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_35_5' class='gform_hidden' value='https:\/\/tillamookhabitat.org\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_35_106\" class=\"gfield gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above field_description_above gfield_visibility_visible\" >Sorry, this form is only applicable for residents in Oregon state.<\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_35_107' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_35\").val(\"2\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_35\").val(\"2\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_35_2' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_35_2' class='gform_fields top_label form_sublabel_above description_above'><li id=\"field_35_6\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label'  >Do you live in Tillamook County?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_6'>\n\t\t\t<li class='gchoice gchoice_35_6_0'>\n\t\t\t\t<input name='input_6' type='radio' value='Yes'  id='choice_35_6_0'    \/>\n\t\t\t\t<label for='choice_35_6_0' id='label_35_6_0'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_6_1'>\n\t\t\t\t<input name='input_6' type='radio' value='No'  id='choice_35_6_1'    \/>\n\t\t\t\t<label for='choice_35_6_1' id='label_35_6_1'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_7\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label'  >Do you own your home?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_7'>\n\t\t\t<li class='gchoice gchoice_35_7_0'>\n\t\t\t\t<input name='input_7' type='radio' value='Yes'  id='choice_35_7_0'    \/>\n\t\t\t\t<label for='choice_35_7_0' id='label_35_7_0'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_7_1'>\n\t\t\t\t<input name='input_7' type='radio' value='No'  id='choice_35_7_1'    \/>\n\t\t\t\t<label for='choice_35_7_1' id='label_35_7_1'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_8\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label'  >Is your home paid off?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_8'>\n\t\t\t<li class='gchoice gchoice_35_8_0'>\n\t\t\t\t<input name='input_8' type='radio' value='Yes'  id='choice_35_8_0'    \/>\n\t\t\t\t<label for='choice_35_8_0' id='label_35_8_0'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_8_1'>\n\t\t\t\t<input name='input_8' type='radio' value='No'  id='choice_35_8_1'    \/>\n\t\t\t\t<label for='choice_35_8_1' id='label_35_8_1'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_9\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label'  >Do you own the land your home is on?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_9'>\n\t\t\t<li class='gchoice gchoice_35_9_0'>\n\t\t\t\t<input name='input_9' type='radio' value='Yes'  id='choice_35_9_0'    \/>\n\t\t\t\t<label for='choice_35_9_0' id='label_35_9_0'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_9_1'>\n\t\t\t\t<input name='input_9' type='radio' value='No'  id='choice_35_9_1'    \/>\n\t\t\t\t<label for='choice_35_9_1' id='label_35_9_1'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_10\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label'  >Is this your primary residence?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_10'>\n\t\t\t<li class='gchoice gchoice_35_10_0'>\n\t\t\t\t<input name='input_10' type='radio' value='Yes'  id='choice_35_10_0'    \/>\n\t\t\t\t<label for='choice_35_10_0' id='label_35_10_0'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_10_1'>\n\t\t\t\t<input name='input_10' type='radio' value='No'  id='choice_35_10_1'    \/>\n\t\t\t\t<label for='choice_35_10_1' id='label_35_10_1'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_11\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label'  >Are you current on your property taxes and homeowner\u2019s insurance?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_11'>\n\t\t\t<li class='gchoice gchoice_35_11_0'>\n\t\t\t\t<input name='input_11' type='radio' value='Yes'  id='choice_35_11_0'    \/>\n\t\t\t\t<label for='choice_35_11_0' id='label_35_11_0'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_11_1'>\n\t\t\t\t<input name='input_11' type='radio' value='No'  id='choice_35_11_1'    \/>\n\t\t\t\t<label for='choice_35_11_1' id='label_35_11_1'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_12\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label'  >Are you in danger of losing your home or being foreclosed?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_12'>\n\t\t\t<li class='gchoice gchoice_35_12_0'>\n\t\t\t\t<input name='input_12' type='radio' value='Yes'  id='choice_35_12_0'    \/>\n\t\t\t\t<label for='choice_35_12_0' id='label_35_12_0'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_12_1'>\n\t\t\t\t<input name='input_12' type='radio' value='No'  id='choice_35_12_1'    \/>\n\t\t\t\t<label for='choice_35_12_1' id='label_35_12_1'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_13\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label'  >Are there any judgments or liens against you or on the property?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_13'>\n\t\t\t<li class='gchoice gchoice_35_13_0'>\n\t\t\t\t<input name='input_13' type='radio' value='Yes'  id='choice_35_13_0'    \/>\n\t\t\t\t<label for='choice_35_13_0' id='label_35_13_0'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_13_1'>\n\t\t\t\t<input name='input_13' type='radio' value='No'  id='choice_35_13_1'    \/>\n\t\t\t\t<label for='choice_35_13_1' id='label_35_13_1'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_14\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_14' >How many months out of the year do you live in the home listed above:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_14' id='input_35_14' type='number' step='any' min='1' max='12' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_35_14\" \/><div class='instruction ' id='gfield_instruction_35_14'>Please enter a number from <strong>1<\/strong> to <strong>12<\/strong>.<\/div><\/div><\/li><li id=\"field_35_15\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label'  >Do you plan on staying in this home for at least three years?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_15'>\n\t\t\t<li class='gchoice gchoice_35_15_0'>\n\t\t\t\t<input name='input_15' type='radio' value='Yes'  id='choice_35_15_0'    \/>\n\t\t\t\t<label for='choice_35_15_0' id='label_35_15_0'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_15_1'>\n\t\t\t\t<input name='input_15' type='radio' value='No'  id='choice_35_15_1'    \/>\n\t\t\t\t<label for='choice_35_15_1' id='label_35_15_1'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_16\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label'  >Type of home:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_16'>\n\t\t\t<li class='gchoice gchoice_35_16_0'>\n\t\t\t\t<input name='input_16' type='radio' value='Built on-site'  id='choice_35_16_0'    \/>\n\t\t\t\t<label for='choice_35_16_0' id='label_35_16_0'>Built on-site<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_16_1'>\n\t\t\t\t<input name='input_16' type='radio' value='Mobile'  id='choice_35_16_1'    \/>\n\t\t\t\t<label for='choice_35_16_1' id='label_35_16_1'>Mobile<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_16_2'>\n\t\t\t\t<input name='input_16' type='radio' value='gf_other_choice'  id='choice_35_16_2'   onfocus=\"jQuery(this).next('input').focus();\" \/>\n\t\t\t\t<input class='small' id='input_35_16_other' name='input_16_other' type='text' value='Other' aria-label='Other' onfocus='jQuery(this).prev(\"input\")[0].click(); if(jQuery(this).val() == \"Other\") { jQuery(this).val(\"\"); }' onblur='if(jQuery(this).val().replace(\" \", \"\") == \"\") { jQuery(this).val(\"Other\"); }'   \/>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_19\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label gfield_label_before_complex'  >List the name, ages and relationship of ALL household residents below:<\/label><style type=\"text\/css\">\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons {\n\t\t\t\t\t\t\tvertical-align: middle !important;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons img {\n\t\t\t\t\t\t\tbackground-color: transparent !important;\n\t\t\t\t\t\t\tbackground-position: 0 0;\n\t\t\t\t\t\t\tbackground-size: 16px 16px !important;\n\t\t\t\t\t\t\tbackground-repeat: no-repeat;\n\t\t\t\t\t\t\tborder: none !important;\n\t\t\t\t\t\t\twidth: 16px !important;\n\t\t\t\t\t\t\theight: 16px !important;\n\t\t\t\t\t\t\topacity: 0.5;\n\t\t\t\t\t\t\ttransition: opacity .5s ease-out;\n\t\t\t\t\t\t    -moz-transition: opacity .5s ease-out;\n\t\t\t\t\t\t    -webkit-transition: opacity .5s ease-out;\n\t\t\t\t\t\t    -o-transition: opacity .5s ease-out;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons a:hover img {\n\t\t\t\t\t\t\topacity: 1.0;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\t<\/style><div class='ginput_container ginput_container_list ginput_list'><table class='gfield_list gfield_list_container'><colgroup><col id='gfield_list_19_col_1' class='gfield_list_col_odd' \/><col id='gfield_list_19_col_2' class='gfield_list_col_even' \/><col id='gfield_list_19_col_3' class='gfield_list_col_odd' \/><col id='gfield_list_19_col_4' class='gfield_list_col_even' \/><\/colgroup><thead><tr><th scope=\"col\">Name<\/th><th scope=\"col\">Relationship<\/th><th scope=\"col\">Age<\/th><td>&nbsp;<\/td><\/tr><\/thead><tbody><tr class='gfield_list_row_odd gfield_list_group'><td class='gfield_list_cell gfield_list_19_cell1' data-label='Name'><input aria-invalid='false'   aria-label='Name, Row ' data-aria-label-template='Name, Row {0}' type='text' name='input_19[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_19_cell2' data-label='Relationship'><input aria-invalid='false'   aria-label='Relationship, Row ' data-aria-label-template='Relationship, Row {0}' type='text' name='input_19[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_19_cell3' data-label='Age'><input aria-invalid='false'   aria-label='Age, Row ' data-aria-label-template='Age, Row {0}' type='text' name='input_19[]' value=''   \/><\/td><td class='gfield_list_icons'>   <a href='javascript:void(0);' class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)' onkeypress='gformAddListItem(this, 0)'><img src='https:\/\/tillamookhabitat.org\/wp-content\/plugins\/gravityforms\/images\/list-add.svg' alt='' title='Add a new row' \/><\/a>   <a href='javascript:void(0);' class='delete_list_item' aria-label='Remove this row' onclick='gformDeleteListItem(this, 0)' onkeypress='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\"><img src='https:\/\/tillamookhabitat.org\/wp-content\/plugins\/gravityforms\/images\/list-remove.svg' alt='' title='Remove this row' \/><\/a><\/td><\/tr><\/tbody><\/table><\/div><\/li><li id=\"field_35_20\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label'  >Is anyone in the household a veteran?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_20'>\n\t\t\t<li class='gchoice gchoice_35_20_0'>\n\t\t\t\t<input name='input_20' type='radio' value='Yes'  id='choice_35_20_0'    \/>\n\t\t\t\t<label for='choice_35_20_0' id='label_35_20_0'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_20_1'>\n\t\t\t\t<input name='input_20' type='radio' value='No'  id='choice_35_20_1'    \/>\n\t\t\t\t<label for='choice_35_20_1' id='label_35_20_1'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_21\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label'  >Is anyone in hour household currently in the military?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_21'>\n\t\t\t<li class='gchoice gchoice_35_21_0'>\n\t\t\t\t<input name='input_21' type='radio' value='Yes'  id='choice_35_21_0'    \/>\n\t\t\t\t<label for='choice_35_21_0' id='label_35_21_0'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_21_1'>\n\t\t\t\t<input name='input_21' type='radio' value='No'  id='choice_35_21_1'    \/>\n\t\t\t\t<label for='choice_35_21_1' id='label_35_21_1'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_35_22' class='gform_previous_button button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_35\").val(\"1\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_35\").val(\"1\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_35_22' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_35\").val(\"3\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_35\").val(\"3\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_35_3' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_35_3' class='gform_fields top_label form_sublabel_above description_above'><li id=\"field_35_63\" class=\"gfield gsection field_sublabel_above field_description_above gfield_visibility_visible\" ><h2 class=\"gsection_title\">Special Needs<\/h2><\/li><li id=\"field_35_25\" class=\"gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above field_description_above gfield_visibility_visible\" >Are you, or is any member of your household:<\/li><li id=\"field_35_23\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label'  >A senior citizen?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_23'>\n\t\t\t<li class='gchoice gchoice_35_23_0'>\n\t\t\t\t<input name='input_23' type='radio' value='Yes'  id='choice_35_23_0'    \/>\n\t\t\t\t<label for='choice_35_23_0' id='label_35_23_0'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_23_1'>\n\t\t\t\t<input name='input_23' type='radio' value='No'  id='choice_35_23_1'    \/>\n\t\t\t\t<label for='choice_35_23_1' id='label_35_23_1'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_24\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label'  >A person with disabilities?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_24'>\n\t\t\t<li class='gchoice gchoice_35_24_0'>\n\t\t\t\t<input name='input_24' type='radio' value='Yes'  id='choice_35_24_0'    \/>\n\t\t\t\t<label for='choice_35_24_0' id='label_35_24_0'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_24_1'>\n\t\t\t\t<input name='input_24' type='radio' value='No'  id='choice_35_24_1'    \/>\n\t\t\t\t<label for='choice_35_24_1' id='label_35_24_1'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_26\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label'  >Does the homeowner or anyone living in the home have a disability that would affect his or her ability to help perform work on the home?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_26'>\n\t\t\t<li class='gchoice gchoice_35_26_0'>\n\t\t\t\t<input name='input_26' type='radio' value='Yes'  id='choice_35_26_0'    \/>\n\t\t\t\t<label for='choice_35_26_0' id='label_35_26_0'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_26_1'>\n\t\t\t\t<input name='input_26' type='radio' value='No'  id='choice_35_26_1'    \/>\n\t\t\t\t<label for='choice_35_26_1' id='label_35_26_1'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_27\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label'  >Are there pets in the home?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_27'>\n\t\t\t<li class='gchoice gchoice_35_27_0'>\n\t\t\t\t<input name='input_27' type='radio' value='Yes'  id='choice_35_27_0'    \/>\n\t\t\t\t<label for='choice_35_27_0' id='label_35_27_0'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_27_1'>\n\t\t\t\t<input name='input_27' type='radio' value='No'  id='choice_35_27_1'    \/>\n\t\t\t\t<label for='choice_35_27_1' id='label_35_27_1'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_28\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_28' >Number\/types:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_28' id='input_35_28' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_35_29' class='gform_previous_button button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_35\").val(\"2\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_35\").val(\"2\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_35_29' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_35\").val(\"4\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_35\").val(\"4\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_35_4' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_35_4' class='gform_fields top_label form_sublabel_above description_above'><li id=\"field_35_62\" class=\"gfield gsection field_sublabel_above field_description_above gfield_visibility_visible\" ><h2 class=\"gsection_title\">Household Income<\/h2><\/li><li id=\"field_35_30\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_30' >The total, combined income before taxes for ALL persons living in the home is: $________________ per year.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_30' id='input_35_30' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_35_31\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_31' >Wages:<\/label><div class='ginput_container ginput_container_text'><input name='input_31' id='input_35_31' type='text' value='' class='medium'    placeholder='$\/MO'  aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_35_32\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_32' >Child Support:<\/label><div class='ginput_container ginput_container_text'><input name='input_32' id='input_35_32' type='text' value='' class='medium'    placeholder='$\/MO'  aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_35_33\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_33' >Pension\/Retirement:<\/label><div class='ginput_container ginput_container_text'><input name='input_33' id='input_35_33' type='text' value='' class='medium'    placeholder='$\/MO'  aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_35_35\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_35' >Social Security:<\/label><div class='ginput_container ginput_container_text'><input name='input_35' id='input_35_35' type='text' value='' class='medium'    placeholder='$\/MO'  aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_35_36\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_36' >Permanent Disability:<\/label><div class='ginput_container ginput_container_text'><input name='input_36' id='input_35_36' type='text' value='' class='medium'    placeholder='$\/MO'  aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_35_37\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_37' >Alimony:<\/label><div class='ginput_container ginput_container_text'><input name='input_37' id='input_35_37' type='text' value='' class='medium'    placeholder='$\/MO'  aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_35_34\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_34' >Other:<\/label><div class='ginput_container ginput_container_text'><input name='input_34' id='input_35_34' type='text' value='' class='medium'    placeholder='$\/MO'  aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_35_38\" class=\"gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above field_description_above gfield_visibility_visible\" >For instance, the most recent income tax return, monthly social security statement, other retirement income statements, employment check stub.  Please note on attached statements frequency of income).<\/li><li id=\"field_35_40\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label'  >Is anyone in the household currently employed?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_40'>\n\t\t\t<li class='gchoice gchoice_35_40_0'>\n\t\t\t\t<input name='input_40' type='radio' value='Yes'  id='choice_35_40_0'    \/>\n\t\t\t\t<label for='choice_35_40_0' id='label_35_40_0'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_40_1'>\n\t\t\t\t<input name='input_40' type='radio' value='No'  id='choice_35_40_1'    \/>\n\t\t\t\t<label for='choice_35_40_1' id='label_35_40_1'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_41\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label'  >Please list names of employee(s), employer(s) and the city\/state of the employer(s):<\/label><div class='ginput_container ginput_container_list ginput_list'><table class='gfield_list gfield_list_container'><colgroup><col id='gfield_list_41_col1' class='gfield_list_col_odd' \/><col id='gfield_list_41_col2' class='gfield_list_col_even' \/><\/colgroup><tbody><tr class='gfield_list_row_odd gfield_list_group'><td class='gfield_list_cell gfield_list_41_cell1' ><input aria-invalid='false'   aria-label='Please list names of employee(s), employer(s) and the city\/state of the employer(s):, Row ' data-aria-label-template='Please list names of employee(s), employer(s) and the city\/state of the employer(s):, Row {0}' type='text' name='input_41[]' value=''   \/><\/td><td class='gfield_list_icons'>   <a href='javascript:void(0);' class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)' onkeypress='gformAddListItem(this, 0)'><img src='https:\/\/tillamookhabitat.org\/wp-content\/plugins\/gravityforms\/images\/list-add.svg' alt='' title='Add a new row' \/><\/a>   <a href='javascript:void(0);' class='delete_list_item' aria-label='Remove this row' onclick='gformDeleteListItem(this, 0)' onkeypress='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\"><img src='https:\/\/tillamookhabitat.org\/wp-content\/plugins\/gravityforms\/images\/list-remove.svg' alt='' title='Remove this row' \/><\/a><\/td><\/tr><\/tbody><\/table><\/div><\/li><li id=\"field_35_43\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_43' >If you have declared bankruptcy, indicate the date it was discharged:<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_43' id='input_35_43' type='text' value='' class='datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_35_43_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_35_43_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_35_43' class='gform_hidden' value='https:\/\/tillamookhabitat.org\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_35_44\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label screen-reader-text gfield_label_before_complex'  ><\/label><div class='ginput_container ginput_container_list ginput_list'><table class='gfield_list gfield_list_container'><colgroup><col id='gfield_list_44_col_1' class='gfield_list_col_odd' \/><col id='gfield_list_44_col_2' class='gfield_list_col_even' \/><col id='gfield_list_44_col_3' class='gfield_list_col_odd' \/><col id='gfield_list_44_col_4' class='gfield_list_col_even' \/><col id='gfield_list_44_col_5' class='gfield_list_col_odd' \/><\/colgroup><thead><tr><th scope=\"col\">Name of bank, savings and loan, credit union, etc.<\/th><th scope=\"col\">Address<\/th><th scope=\"col\">Account Number<\/th><th scope=\"col\">Current Balance ($)<\/th><td>&nbsp;<\/td><\/tr><\/thead><tbody><tr class='gfield_list_row_odd gfield_list_group'><td class='gfield_list_cell gfield_list_44_cell1' data-label='Name of bank, savings and loan, credit union, etc.'><input aria-invalid='false'   aria-label='Name of bank, savings and loan, credit union, etc., Row ' data-aria-label-template='Name of bank, savings and loan, credit union, etc., Row {0}' type='text' name='input_44[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_44_cell2' data-label='Address'><input aria-invalid='false'   aria-label='Address, Row ' data-aria-label-template='Address, Row {0}' type='text' name='input_44[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_44_cell3' data-label='Account Number'><input aria-invalid='false'   aria-label='Account Number, Row ' data-aria-label-template='Account Number, Row {0}' type='text' name='input_44[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_44_cell4' data-label='Current Balance ($)'><input aria-invalid='false'   aria-label='Current Balance ($), Row ' data-aria-label-template='Current Balance ($), Row {0}' type='text' name='input_44[]' value=''   \/><\/td><td class='gfield_list_icons'>   <a href='javascript:void(0);' class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)' onkeypress='gformAddListItem(this, 0)'><img src='https:\/\/tillamookhabitat.org\/wp-content\/plugins\/gravityforms\/images\/list-add.svg' alt='' title='Add a new row' \/><\/a>   <a href='javascript:void(0);' class='delete_list_item' aria-label='Remove this row' onclick='gformDeleteListItem(this, 0)' onkeypress='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\"><img src='https:\/\/tillamookhabitat.org\/wp-content\/plugins\/gravityforms\/images\/list-remove.svg' alt='' title='Remove this row' \/><\/a><\/td><\/tr><\/tbody><\/table><\/div><\/li><li id=\"field_35_61\" class=\"gfield gsection field_sublabel_above field_description_above gfield_visibility_visible\" ><h2 class=\"gsection_title\"><\/h2><\/li><li id=\"field_35_47\" class=\"gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above field_description_above gfield_visibility_visible\" ><\/li><li id=\"field_35_48\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_48' >Mortgage Payment:<\/label><div class='ginput_container ginput_container_text'><input name='input_48' id='input_35_48' type='text' value='' class='medium'    placeholder='$\/MO'  aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_35_49\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_49' >Medical\/Dental:<\/label><div class='ginput_container ginput_container_text'><input name='input_49' id='input_35_49' type='text' value='' class='medium'    placeholder='$\/MO'  aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_35_50\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_50' >Lot rental:<\/label><div class='ginput_container ginput_container_text'><input name='input_50' id='input_35_50' type='text' value='' class='medium'    placeholder='$\/MO'  aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_35_51\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_51' >HOA Dues:<\/label><div class='ginput_container ginput_container_text'><input name='input_51' id='input_35_51' type='text' value='' class='medium'    placeholder='$\/MO'  aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_35_52\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_52' >Car payment:<\/label><div class='ginput_container ginput_container_text'><input name='input_52' id='input_35_52' type='text' value='' class='medium'    placeholder='$\/MO'  aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_35_53\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_53' >Child\/Spousal Support:<\/label><div class='ginput_container ginput_container_text'><input name='input_53' id='input_35_53' type='text' value='' class='medium'    placeholder='$\/MO'  aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_35_54\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_54' >Utilities:<\/label><div class='ginput_container ginput_container_text'><input name='input_54' id='input_35_54' type='text' value='' class='medium'    placeholder='$\/MO'  aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_35_55\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_55' >Child Care:<\/label><div class='ginput_container ginput_container_text'><input name='input_55' id='input_35_55' type='text' value='' class='medium'    placeholder='$\/MO'  aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_35_56\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_56' >Cell Phone:<\/label><div class='ginput_container ginput_container_text'><input name='input_56' id='input_35_56' type='text' value='' class='medium'    placeholder='$\/MO'  aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_35_57\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_57' >Business Expenses:<\/label><div class='ginput_container ginput_container_text'><input name='input_57' id='input_35_57' type='text' value='' class='medium'    placeholder='$\/MO'  aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_35_58\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_58' >Student loans:<\/label><div class='ginput_container ginput_container_text'><input name='input_58' id='input_35_58' type='text' value='' class='medium'    placeholder='$\/MO'  aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_35_60\" class=\"gfield gsection field_sublabel_above field_description_above gfield_visibility_visible\" ><h2 class=\"gsection_title\"><\/h2><\/li><li id=\"field_35_59\" class=\"gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above field_description_above gfield_visibility_visible\" ><\/li><li id=\"field_35_64\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label'  >Motor Vehicle<\/label><div class='gfield_description' id='gfield_description_35_64'>Is asset paid off:<\/div><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_64'>\n\t\t\t<li class='gchoice gchoice_35_64_0'>\n\t\t\t\t<input name='input_64' type='radio' value='Yes'  id='choice_35_64_0'    \/>\n\t\t\t\t<label for='choice_35_64_0' id='label_35_64_0'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_64_1'>\n\t\t\t\t<input name='input_64' type='radio' value='No'  id='choice_35_64_1'    \/>\n\t\t\t\t<label for='choice_35_64_1' id='label_35_64_1'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_65\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_65' >Unpaid Balance:<\/label><div class='ginput_container ginput_container_number'><input name='input_65' id='input_35_65' type='number' step='any'   value='' class='medium'      aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_35_66\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_66' >Months left to pay<\/label><div class='ginput_container ginput_container_number'><input name='input_66' id='input_35_66' type='number' step='any'   value='' class='medium'      aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_35_67\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label'  >Additional Motor Vehicle<\/label><div class='gfield_description' id='gfield_description_35_67'>Is asset paid off:<\/div><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_67'>\n\t\t\t<li class='gchoice gchoice_35_67_0'>\n\t\t\t\t<input name='input_67' type='radio' value='Yes'  id='choice_35_67_0'    \/>\n\t\t\t\t<label for='choice_35_67_0' id='label_35_67_0'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_67_1'>\n\t\t\t\t<input name='input_67' type='radio' value='No'  id='choice_35_67_1'    \/>\n\t\t\t\t<label for='choice_35_67_1' id='label_35_67_1'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_70\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_70' >Unpaid Balance:<\/label><div class='ginput_container ginput_container_number'><input name='input_70' id='input_35_70' type='number' step='any'   value='' class='medium'      aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_35_71\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_71' >Months left to pay<\/label><div class='ginput_container ginput_container_number'><input name='input_71' id='input_35_71' type='number' step='any'   value='' class='medium'      aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_35_68\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label'  >Boats<\/label><div class='gfield_description' id='gfield_description_35_68'>Is asset paid off:<\/div><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_68'>\n\t\t\t<li class='gchoice gchoice_35_68_0'>\n\t\t\t\t<input name='input_68' type='radio' value='Yes'  id='choice_35_68_0'    \/>\n\t\t\t\t<label for='choice_35_68_0' id='label_35_68_0'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_68_1'>\n\t\t\t\t<input name='input_68' type='radio' value='No'  id='choice_35_68_1'    \/>\n\t\t\t\t<label for='choice_35_68_1' id='label_35_68_1'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_72\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_72' >Unpaid Balance:<\/label><div class='ginput_container ginput_container_number'><input name='input_72' id='input_35_72' type='number' step='any'   value='' class='medium'      aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_35_73\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_73' >Months left to pay<\/label><div class='ginput_container ginput_container_number'><input name='input_73' id='input_35_73' type='number' step='any'   value='' class='medium'      aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_35_69\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label'  >Motorcycle(s)<\/label><div class='gfield_description' id='gfield_description_35_69'>Is asset paid off:<\/div><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_69'>\n\t\t\t<li class='gchoice gchoice_35_69_0'>\n\t\t\t\t<input name='input_69' type='radio' value='Yes'  id='choice_35_69_0'    \/>\n\t\t\t\t<label for='choice_35_69_0' id='label_35_69_0'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_69_1'>\n\t\t\t\t<input name='input_69' type='radio' value='No'  id='choice_35_69_1'    \/>\n\t\t\t\t<label for='choice_35_69_1' id='label_35_69_1'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_74\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_74' >Months left to pay<\/label><div class='ginput_container ginput_container_number'><input name='input_74' id='input_35_74' type='number' step='any'   value='' class='medium'      aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_35_75\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_75' >Months left to pay<\/label><div class='ginput_container ginput_container_number'><input name='input_75' id='input_35_75' type='number' step='any'   value='' class='medium'      aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_35_76\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label gfield_label_before_complex'  >Credit Card<\/label><div class='ginput_container ginput_container_list ginput_list'><table class='gfield_list gfield_list_container'><colgroup><col id='gfield_list_76_col_1' class='gfield_list_col_odd' \/><col id='gfield_list_76_col_2' class='gfield_list_col_even' \/><col id='gfield_list_76_col_3' class='gfield_list_col_odd' \/><\/colgroup><thead><tr><th scope=\"col\">Type<\/th><th scope=\"col\">$<\/th><td>&nbsp;<\/td><\/tr><\/thead><tbody><tr class='gfield_list_row_odd gfield_list_group'><td class='gfield_list_cell gfield_list_76_cell1' data-label='Type'><input aria-invalid='false'   aria-label='Type, Row ' data-aria-label-template='Type, Row {0}' type='text' name='input_76[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_76_cell2' data-label='$'><input aria-invalid='false'   aria-label='$, Row ' data-aria-label-template='$, Row {0}' type='text' name='input_76[]' value=''   \/><\/td><td class='gfield_list_icons'>   <a href='javascript:void(0);' class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)' onkeypress='gformAddListItem(this, 0)'><img src='https:\/\/tillamookhabitat.org\/wp-content\/plugins\/gravityforms\/images\/list-add.svg' alt='' title='Add a new row' \/><\/a>   <a href='javascript:void(0);' class='delete_list_item' aria-label='Remove this row' onclick='gformDeleteListItem(this, 0)' onkeypress='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\"><img src='https:\/\/tillamookhabitat.org\/wp-content\/plugins\/gravityforms\/images\/list-remove.svg' alt='' title='Remove this row' \/><\/a><\/td><\/tr><\/tbody><\/table><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_35_77' class='gform_previous_button button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_35\").val(\"3\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_35\").val(\"3\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_35_77' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_35\").val(\"5\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_35\").val(\"5\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_35_5' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_35_5' class='gform_fields top_label form_sublabel_above description_above'><li id=\"field_35_78\" class=\"gfield gsection field_sublabel_above field_description_above gfield_visibility_visible\" ><h2 class=\"gsection_title\">Family Background<\/h2><\/li><li id=\"field_35_79\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label'  >Are you or any member of your household required to register as a sex offender in any state?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_79'>\n\t\t\t<li class='gchoice gchoice_35_79_0'>\n\t\t\t\t<input name='input_79' type='radio' value='Yes'  id='choice_35_79_0'    \/>\n\t\t\t\t<label for='choice_35_79_0' id='label_35_79_0'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_79_1'>\n\t\t\t\t<input name='input_79' type='radio' value='No'  id='choice_35_79_1'    \/>\n\t\t\t\t<label for='choice_35_79_1' id='label_35_79_1'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_80\" class=\"gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_80' >In which state is this registration?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_80' id='input_35_80' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_35_81\" class=\"gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above field_description_above gfield_visibility_visible\" >Habitat for Humanity screens all potential applicants on the National Sex Offender Public Registry.<\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_35_82' class='gform_previous_button button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_35\").val(\"4\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_35\").val(\"4\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_35_82' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_35\").val(\"6\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_35\").val(\"6\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_35_6' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_35_6' class='gform_fields top_label form_sublabel_above description_above'><li id=\"field_35_83\" class=\"gfield gsection field_sublabel_above field_description_above gfield_visibility_visible\" ><h2 class=\"gsection_title\">Home Information<\/h2><\/li><li id=\"field_35_84\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label'  >Style of home:<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_84'>\n\t\t\t<li class='gchoice gchoice_35_84_0'>\n\t\t\t\t<input name='input_84' type='radio' value='1 Story'  id='choice_35_84_0'    \/>\n\t\t\t\t<label for='choice_35_84_0' id='label_35_84_0'>1 Story<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_84_1'>\n\t\t\t\t<input name='input_84' type='radio' value='2 Story'  id='choice_35_84_1'    \/>\n\t\t\t\t<label for='choice_35_84_1' id='label_35_84_1'>2 Story<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_84_2'>\n\t\t\t\t<input name='input_84' type='radio' value='Ranch'  id='choice_35_84_2'    \/>\n\t\t\t\t<label for='choice_35_84_2' id='label_35_84_2'>Ranch<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_85\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_85' >Year built:<\/label><div class='ginput_container ginput_container_number'><input name='input_85' id='input_35_85' type='number' step='any'   value='' class='medium'      aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_35_86\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_86' >year purchase:<\/label><div class='ginput_container ginput_container_number'><input name='input_86' id='input_35_86' type='number' step='any'   value='' class='medium'      aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_35_88\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label gfield_label_before_complex'  >Type of work needed:<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_35_88'><li class='gchoice gchoice_35_88_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_88.1' type='checkbox'  value='Window replacement'  id='choice_35_88_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_88_1' id='label_35_88_1'>Window replacement<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_88_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_88.2' type='checkbox'  value='Deck (repair only)'  id='choice_35_88_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_88_2' id='label_35_88_2'>Deck (repair only)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_88_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_88.3' type='checkbox'  value='Handicap ramp'  id='choice_35_88_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_88_3' id='label_35_88_3'>Handicap ramp<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_88_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_88.4' type='checkbox'  value='Exterior paint'  id='choice_35_88_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_88_4' id='label_35_88_4'>Exterior paint<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_88_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_88.5' type='checkbox'  value='Landscaping'  id='choice_35_88_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_88_5' id='label_35_88_5'>Landscaping<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_88_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_88.6' type='checkbox'  value='Yard work'  id='choice_35_88_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_88_6' id='label_35_88_6'>Yard work<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_89\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label gfield_label_before_complex'  >Type of siding and trim of home:<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_35_89'><li class='gchoice gchoice_35_89_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_89.1' type='checkbox'  value='Wood'  id='choice_35_89_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_89_1' id='label_35_89_1'>Wood<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_89_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_89.2' type='checkbox'  value='Brick'  id='choice_35_89_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_89_2' id='label_35_89_2'>Brick<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_89_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_89.3' type='checkbox'  value='Stucco'  id='choice_35_89_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_89_3' id='label_35_89_3'>Stucco<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_89_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_89.4' type='checkbox'  value='Aluminum'  id='choice_35_89_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_89_4' id='label_35_89_4'>Aluminum<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_89_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_89.5' type='checkbox'  value='Vinyl'  id='choice_35_89_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_89_5' id='label_35_89_5'>Vinyl<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_90\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label gfield_label_before_complex'  >Does property have a:<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_35_90'><li class='gchoice gchoice_35_90_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_90.1' type='checkbox'  value='Garage'  id='choice_35_90_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_90_1' id='label_35_90_1'>Garage<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_90_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_90.2' type='checkbox'  value='Shop'  id='choice_35_90_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_90_2' id='label_35_90_2'>Shop<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_90_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_90.3' type='checkbox'  value='Shed'  id='choice_35_90_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_90_3' id='label_35_90_3'>Shed<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_35_91' class='gform_previous_button button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_35\").val(\"5\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_35\").val(\"5\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_35_91' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_35\").val(\"7\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_35\").val(\"7\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_35_7' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_35_7' class='gform_fields top_label form_sublabel_above description_above'><li id=\"field_35_92\" class=\"gfield gsection field_sublabel_above field_description_above gfield_visibility_visible\" ><h2 class=\"gsection_title\">Repairs Needed<\/h2><\/li><li id=\"field_35_93\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_93' >In this section, please describe the type of work you would like done on your home.   Attach a separate piece of paper if there is not enough space to list all repairs.  Remember that the items listed below will be considered for repair, but the final decision on what work can be done with our time and financial resources will be made at the discretion of our Ramps &amp; Rails Committee.<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_93' id='input_35_93' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_35_94\" class=\"gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above field_description_above gfield_visibility_visible\" ><\/li><li id=\"field_35_95\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_95' >House painting. Please describe:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_95' id='input_35_95' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_35_96\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_96' >Minor siding and trim repair. Please describe:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_96' id='input_35_96' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_35_97\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_97' >Board replacement in porch, stair, or ramps. Please describe:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_97' id='input_35_97' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_35_98\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_98' >Yard work (including pruning, trimming, weeding). Please describe:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_98' id='input_35_98' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_35_99\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_99' >Junk removal. Please describe:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_99' id='input_35_99' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_35_100\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_35_100' >Critical Home Repairs (CHR): Please describe any further repairs that may be necessary.<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_100' id='input_35_100' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_35_101' class='gform_previous_button button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_35\").val(\"6\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_35\").val(\"6\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_35_101' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_35\").val(\"8\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_35\").val(\"8\");  jQuery(\"#gform_35\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_35_8' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_35_8' class='gform_fields top_label form_sublabel_above description_above'><li id=\"field_35_102\" class=\"gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above field_description_above gfield_visibility_visible\" >By completing this application, I certify that the information I have provided on this application is accurate and that I own the property at the address provided.  I have no present intention to move or offer my home for sale for at least three years.  I confirm that, except for the conditions listed in this application, my home is a safe place for volunteers. \n<br\/><br\/>\nCompletion of this application signifies that I understand that if I am approved and there are costs for the repairs, I agree to pay for the cost of the repairs and may be able to qualify for a no interest loan for those costs and make monthly payments until the balance is paid off.  \n<br\/><br\/>\nI understand that the people who may work on my house may be unpaid volunteers or staff; that few, if any are skilled in the building trades, and that \u2018Ramps & Rails\u2019 makes NO WARRANTIES, EXPRESSED OR IMPLIED REGARDING ANY MATERIALS USED OR WORK DONE BY ANYONE AT MY HOUSE.  \n<br\/><br\/>\nI understand that the people who may work on my house may be unpaid volunteers or staff; that few, if any are skilled in the building trades, and that \u2018Ramps & Rails\u2019 makes NO WARRANTIES, EXPRESSED OR IMPLIED REGARDING ANY MATERIALS USED OR WORK DONE BY ANYONE AT MY HOUSE.  \n<br\/><br\/>\nI also understand that Habitat for Humanity screens all applicant families on the sex offender registry.  By completing this application, I am submitting myself to such an inquiry.  I further understand that by completing this application, I am submitting myself to a criminal background check.\n<br\/><br\/>\nI hereby release Tillamook County Habitat for Humanity and any of its affiliated organization from all actions, claims or demands that I, my assignees, heirs, guardians, and legal representatives now have or may hereafter have for injury or damages resulting from my participation in any Tillamook County Habitat for Humanity activities.<\/li><li id=\"field_35_103\" class=\"gfield field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label gfield_label_before_complex'  >By completing this application, I certify that the information I have provided on this application is accurate and that I own the property at the address provided.  I have no present intention to move or offer my home for sale for at least three years.  I confirm that, except for the conditions listed in this application, my home is a safe place for volunteers.<\/label><div class='gfield_description' id='gfield_description_35_103'>Completion of this application signifies that I understand that if I am approved and there are costs for the repairs, I agree to pay for the cost of the repairs and may be able to qualify for a no interest loan for those costs and make monthly payments until the balance is paid off.  \n<br\/><br\/>\nI understand that the people who may work on my house may be unpaid volunteers or staff; that few, if any are skilled in the building trades, and that \u2018Ramps & Rails\u2019 makes NO WARRANTIES, EXPRESSED OR IMPLIED REGARDING ANY MATERIALS USED OR WORK DONE BY ANYONE AT MY HOUSE.  \n<br\/><br\/>\nI understand that the people who may work on my house may be unpaid volunteers or staff; that few, if any are skilled in the building trades, and that \u2018Ramps & Rails\u2019 makes NO WARRANTIES, EXPRESSED OR IMPLIED REGARDING ANY MATERIALS USED OR WORK DONE BY ANYONE AT MY HOUSE.  \n<br\/><br\/>\nI also understand that Habitat for Humanity screens all applicant families on the sex offender registry.  By completing this application, I am submitting myself to such an inquiry.  I further understand that by completing this application, I am submitting myself to a criminal background check.\n<br\/><br\/><\/div><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_35_103'><li class='gchoice gchoice_35_103_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_103.1' type='checkbox'  value='I hereby release Tillamook County Habitat for Humanity and any of its affiliated organization from all actions, claims or demands that I, my assignees, heirs, guardians, and legal representatives now have or may hereafter have for injury or damages resulting from my participation in any Tillamook County Habitat for Humanity activities.'  id='choice_35_103_1'   aria-describedby=\"gfield_description_35_103\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_35_103_1' id='label_35_103_1'>I hereby release Tillamook County Habitat for Humanity and any of its affiliated organization from all actions, claims or demands that I, my assignees, heirs, guardians, and legal representatives now have or may hereafter have for injury or damages resulting from my participation in any Tillamook County Habitat for Humanity activities.<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_108\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible\" ><label class='gfield_label gfield_label_before_complex'  >Do you want to receive our newsletter?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_35_108'><li class='gchoice gchoice_35_108_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.1' type='checkbox'  value='Yes'  id='choice_35_108_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_108_1' id='label_35_108_1'>Yes<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_108_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.2' type='checkbox'  value='No'  id='choice_35_108_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_108_2' id='label_35_108_2'>No<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><\/ul><\/div>\n        <div class='gform_page_footer top_label'><input type='submit' id='gform_previous_button_35' class='gform_previous_button button' value='Previous'  onclick='if(window[\"gf_submitting_35\"]){return false;}  if( !jQuery(\"#gform_35\")[0].checkValidity || jQuery(\"#gform_35\")[0].checkValidity()){window[\"gf_submitting_35\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_35\"]){return false;} if( !jQuery(\"#gform_35\")[0].checkValidity || jQuery(\"#gform_35\")[0].checkValidity()){window[\"gf_submitting_35\"]=true;}  jQuery(\"#gform_35\").trigger(\"submit\",[true]); }' \/> <input type='submit' id='gform_submit_button_35' class='gform_button button' value='Submit'  onclick='if(window[\"gf_submitting_35\"]){return false;}  if( !jQuery(\"#gform_35\")[0].checkValidity || jQuery(\"#gform_35\")[0].checkValidity()){window[\"gf_submitting_35\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_35\"]){return false;} if( !jQuery(\"#gform_35\")[0].checkValidity || jQuery(\"#gform_35\")[0].checkValidity()){window[\"gf_submitting_35\"]=true;}  jQuery(\"#gform_35\").trigger(\"submit\",[true]); }' \/> \n            <input type='hidden' class='gform_hidden' name='is_submit_35' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='35' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_35' value='WyJbXSIsImNiOGEzMmZjNGFkYThhNWFkM2YyN2U5YTZiNzIyYWU5Il0=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_target_page_number_35' id='gform_target_page_number_35' value='2' \/>\n            <input type='hidden' class='gform_hidden' name='gform_source_page_number_35' id='gform_source_page_number_35' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/div><\/div>\n                        <\/form>\n                        <\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":27,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"xn-wppe-expiration":[],"xn-wppe-expiration-action":[],"xn-wppe-expiration-prefix":[],"footnotes":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v18.1 (Yoast SEO v18.2) - 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