{"id":164,"date":"2023-06-06T10:45:57","date_gmt":"2023-06-06T14:45:57","guid":{"rendered":"https:\/\/fisherforms.sjf.edu\/alumni\/?page_id=164"},"modified":"2023-06-06T10:45:57","modified_gmt":"2023-06-06T14:45:57","slug":"payroll-deduction-donation","status":"publish","type":"page","link":"https:\/\/fisherforms.sjf.edu\/alumni\/payroll-deduction-donation\/","title":{"rendered":"Payroll Deduction Donation"},"content":{"rendered":"<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),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),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_31' style='display:none'><div id='gf_31' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Payroll Deduction<\/h2>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_31'  action='\/alumni\/wp-json\/wp\/v2\/pages\/164#gf_31' data-formid='31' novalidate>\n        <div id='gf_progressbar_wrapper_31' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>3<\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_33' style='width:33%;'><span>33%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_31_1' class='gform_page ' data-js='page-field-id-1' >\n                                    <div class='gform_page_fields'><div id='gform_fields_31' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_31_1\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_31_1\" ><h1><strong>Thank you for your support through payroll deduction. Please read the information below before completing this form.<\/strong><\/h1>\n<ul>\n<li>Payroll deduction installments must be at least $2.00<\/li>\n<li>All deductions will occur on a bi-weekly basis<\/li>\n<li>You will have the option to give for six months, nine months, one year, three years or five years<\/li>\n<\/ul> <\/div><fieldset id=\"field_31_3\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_31_3\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_31_3'>\n                            \n                            <span id='input_31_3_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_3.3' id='input_31_3_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_31_3_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_31_3_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_3.6' id='input_31_3_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_31_3_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><\/fieldset><div id=\"field_31_4\" class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_31_4\" ><label class='gfield_label gform-field-label' for='input_31_4'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_4' id='input_31_4' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform_page_footer before'>\n                         <input type='button' id='gform_next_button_31_18' class='gform_next_button gform-theme-button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_31\").val(\"2\");  jQuery(\"#gform_31\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_31\").val(\"2\");  jQuery(\"#gform_31\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_31_2' class='gform_page' data-js='page-field-id-18' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_31_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_31_5\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_31_5\" ><h3 class=\"gsection_title\">Donation Options<\/h3><\/div><div id=\"field_31_6\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_31_6\" ><label class='gfield_label gform-field-label' for='input_31_6'>Donation Per Pay Period<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_31_6' type='text' value='' class='large'    placeholder='$' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_31_7\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_31_7\" ><legend class='gfield_label gform-field-label' >Installment Schedule<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_31_7'>\n\t\t\t<div class='gchoice gchoice_31_7_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='Six months (12 installments)'  id='choice_31_7_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_31_7_0' id='label_31_7_0' class='gform-field-label gform-field-label--type-inline'>Six months (12 installments)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_31_7_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='Nine months (18 installments)'  id='choice_31_7_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_31_7_1' id='label_31_7_1' class='gform-field-label gform-field-label--type-inline'>Nine months (18 installments)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_31_7_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='One year (26 installments)'  id='choice_31_7_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_31_7_2' id='label_31_7_2' class='gform-field-label gform-field-label--type-inline'>One year (26 installments)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_31_7_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='Three years (78 installments)'  id='choice_31_7_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_31_7_3' id='label_31_7_3' class='gform-field-label gform-field-label--type-inline'>Three years (78 installments)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_31_7_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='Five years (130 installments)'  id='choice_31_7_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_31_7_4' id='label_31_7_4' class='gform-field-label gform-field-label--type-inline'>Five years (130 installments)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/fieldset><div id=\"field_31_8\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_31_8\" ><p>You can invest in our students, our people, and our mission by joining the Spire Society!  If you would like to become a member, please do the following: 1) Choose the three year installment schedule option; 2) Input $38.46 or more for your donation amount per pay period for a total minimum donation of $1,000 per year for three years, and 3) Designate your gift to one or more annual fund designations below (non-annual fund designations are not eligible for Spire Society membership).  Thank you for your investment! <\/p><\/div><fieldset id=\"field_31_9\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_31_9\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Spire Membership<\/legend><div class='ginput_container ginput_container_consent'><input name='input_9.1' id='input_31_9_1' type='checkbox' value='1'    aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_31_9_1' >Yes, I want to join Spire Society!<\/label><input type='hidden' name='input_9.2' value='Yes, I want to join Spire Society!' class='gform_hidden' \/><input type='hidden' name='input_9.3' value='2' class='gform_hidden' \/><\/div><\/fieldset><div id=\"field_31_21\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_31_21\" ><label class='gfield_label gform-field-label' for='input_31_21'>Please indicate how you would like to be recognized on the Spire Society donor roll:<\/label><div class='ginput_container ginput_container_text'><input name='input_21' id='input_31_21' type='text' value='' class='large'  aria-describedby=\"gfield_description_31_21\"    aria-invalid=\"false\"   \/> <\/div><div class='gfield_description' id='gfield_description_31_21'>Ex. John A. '79 and Julie B. Smith\n<\/div><\/div><div id=\"field_31_10\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_31_10\" ><p>Please indicate the area(s) you wish to support (up to five) below. Payments will be split evenly among all selected <\/p><\/div><fieldset id=\"field_31_11\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_31_11\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Gift Designations<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_31_11'><div class='gchoice gchoice_31_11_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.1' type='checkbox'  value='Area of Greatest Need'  id='choice_31_11_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_31_11_1' id='label_31_11_1' class='gform-field-label gform-field-label--type-inline'>Area of Greatest Need<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_31_11_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.2' type='checkbox'  value='Fisher Fund for Financial Aid'  id='choice_31_11_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_31_11_2' id='label_31_11_2' class='gform-field-label gform-field-label--type-inline'>Fisher Fund for Financial Aid<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_31_11_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.3' type='checkbox'  value='School of Arts and Sciences Annual Fund'  id='choice_31_11_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_31_11_3' id='label_31_11_3' class='gform-field-label gform-field-label--type-inline'>School of Arts and Sciences Annual Fund<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_31_11_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.4' type='checkbox'  value='School of Business Annual Fund'  id='choice_31_11_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_31_11_4' id='label_31_11_4' class='gform-field-label gform-field-label--type-inline'>School of Business Annual Fund<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_31_11_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.5' type='checkbox'  value='Wegmans School of Nursing Annual Fund'  id='choice_31_11_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_31_11_5' id='label_31_11_5' class='gform-field-label gform-field-label--type-inline'>Wegmans School of Nursing Annual Fund<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_31_11_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.6' type='checkbox'  value='Wegmans School of Pharmacy Annual Fund'  id='choice_31_11_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_31_11_6' id='label_31_11_6' class='gform-field-label gform-field-label--type-inline'>Wegmans School of Pharmacy Annual Fund<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_31_11_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.7' type='checkbox'  value='Ralph C. Wilson, Jr. School of Education Annual Fund'  id='choice_31_11_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_31_11_7' id='label_31_11_7' class='gform-field-label gform-field-label--type-inline'>Ralph C. Wilson, Jr. School of Education Annual Fund<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_31_11_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.8' type='checkbox'  value='Athletics Annual Fund'  id='choice_31_11_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_31_11_8' id='label_31_11_8' class='gform-field-label gform-field-label--type-inline'>Athletics Annual Fund<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_31_11_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.9' type='checkbox'  value='Lavery Library Annual Fund'  id='choice_31_11_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_31_11_9' id='label_31_11_9' class='gform-field-label gform-field-label--type-inline'>Lavery Library Annual Fund<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_31_11_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.11' type='checkbox'  value='Student Life Annual Fund'  id='choice_31_11_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_31_11_11' id='label_31_11_11' class='gform-field-label gform-field-label--type-inline'>Student Life Annual Fund<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_31_11_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.12' type='checkbox'  value='Presidential Initiatives Fund'  id='choice_31_11_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_31_11_12' id='label_31_11_12' class='gform-field-label gform-field-label--type-inline'>Presidential Initiatives Fund<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_31_11_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.13' type='checkbox'  value='Other'  id='choice_31_11_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_31_11_13' id='label_31_11_13' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/fieldset><div id=\"field_31_20\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_31_20\" ><label class='gfield_label gform-field-label' for='input_31_20'>Other designation:<\/label><div class='ginput_container ginput_container_text'><input name='input_20' id='input_31_20' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_31_12\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_31_12\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Consent<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_12.1' id='input_31_12_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_31_12\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_31_12_1' >This information is correct.<\/label><input type='hidden' name='input_12.2' value='This information is correct.' class='gform_hidden' \/><input type='hidden' name='input_12.3' value='2' class='gform_hidden' \/><\/div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_31_12'>I have reviewed the above information and have verified that it is correct.<\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer before'>\n                        <input type='button' id='gform_previous_button_31_19' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_31\").val(\"1\");  jQuery(\"#gform_31\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_31\").val(\"1\");  jQuery(\"#gform_31\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_31_19' class='gform_next_button gform-theme-button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_31\").val(\"3\");  jQuery(\"#gform_31\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_31\").val(\"3\");  jQuery(\"#gform_31\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_31_3' class='gform_page' data-js='page-field-id-19' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_31_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_31_13\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_31_13\" ><h3 class=\"gsection_title\">Personal Information<\/h3><\/div><div id=\"field_31_14\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_31_14\" ><label class='gfield_label gform-field-label' for='input_31_14'>Preferred First Name<\/label><div class='ginput_container ginput_container_text'><input name='input_14' id='input_31_14' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_31_15\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_31_15\" ><label class='gfield_label gform-field-label' for='input_31_15'>Current Job Title<\/label><div class='ginput_container ginput_container_text'><input name='input_15' id='input_31_15' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_31_16\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_31_16\" ><label class='gfield_label gform-field-label' for='input_31_16'>Department<\/label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_31_16' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_31_17\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_31_17\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Please indicate your terms of employment at Fisher:<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_31_17'><div class='gchoice gchoice_31_17_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.1' type='checkbox'  value='9 month'  id='choice_31_17_1'   aria-describedby=\"gfield_description_31_17\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_31_17_1' id='label_31_17_1' class='gform-field-label gform-field-label--type-inline'>9 month<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_31_17_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.2' type='checkbox'  value='10 month'  id='choice_31_17_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_31_17_2' id='label_31_17_2' 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