{"id":8065,"date":"2024-11-14T13:27:35","date_gmt":"2024-11-14T12:27:35","guid":{"rendered":"https:\/\/www.bogaerstalen.nl\/subscribe-2\/"},"modified":"2024-11-14T13:27:45","modified_gmt":"2024-11-14T12:27:45","slug":"subscribe-2","status":"publish","type":"page","link":"https:\/\/www.bogaerstalen.nl\/en\/subscribe-2\/","title":{"rendered":"Subscribe"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"8065\" class=\"elementor elementor-8065 elementor-3618\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-5b10e464 e-flex e-con-boxed e-con e-parent\" data-id=\"5b10e464\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-271ab0b9 elementor-widget elementor-widget-text-editor\" data-id=\"271ab0b9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_19' ><div id='gf_19' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n                            <h3 class=\"gform_title\">Pre-registration Enrollment form \/ make a no-obligation appointment for intake<\/h3>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_19'  action='\/en\/wp-json\/wp\/v2\/pages\/8065#gf_19' data-formid='19' novalidate>\n        <div id='gf_progressbar_wrapper_19' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<h3 class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>5<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/h3>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_20' style='width:20%;'><span>20%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_19_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><ul id='gform_fields_19' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_19_45\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>I hereby provisionally register for: (NB. at www.bogaerstalen.nl\/winkel you will save a \u20ac25 administration fee).<\/span><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_19_45'><li class='gchoice gchoice_19_45_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.1' type='checkbox'  value='Blended Learning (10 clock hours individually or 20 clock hours in small group up to max. 4 pers. and min. 30 clock hours self-study package online - package price = 1350,-. (both physical and virtual possible). '  id='choice_19_45_1'   aria-describedby=\"gfield_description_19_45\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_19_45_1' id='label_19_45_1' class='gform-field-label gform-field-label--type-inline'>Blended Learning (10 clock hours individually or 20 clock hours in small group up to max. 4 pers. and min. 30 clock hours self-study package online &#8211; package price = 1350,-. (both physical and virtual possible). <\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_45_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.2' type='checkbox'  value='Individual lessons 10 x 110.00 (both physical and virtual possible)'  id='choice_19_45_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_45_2' id='label_19_45_2' class='gform-field-label gform-field-label--type-inline'>Individual lessons 10 x 110.00 (both physical and virtual possible)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_45_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.3' type='checkbox'  value='Dutch\/NT2 - Integration only for self-pay Blended Learning \u20ac 1350 (10 individual lessons and 30 group lessons in Tilburg (Studiehuis) physical and in small group \u20ac 19,50 p.u.'  id='choice_19_45_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_45_3' id='label_19_45_3' class='gform-field-label gform-field-label--type-inline'>Dutch\/NT2 &#8211; Integration only for self-pay Blended Learning \u20ac 1350 (10 individual lessons and 30 group lessons in Tilburg (Studiehuis) physical and in small group \u20ac 19,50 p.u.<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_45_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.4' type='checkbox'  value='Language Weekend French In France (Auxi le Ch\u00e2teau) \u20ac 495 on request'  id='choice_19_45_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_45_4' id='label_19_45_4' class='gform-field-label gform-field-label--type-inline'>Language Weekend French In France (Auxi le Ch\u00e2teau) \u20ac 495 on request<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_45_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.5' type='checkbox'  value='E-learning; unlimited online practice with an individual language package'  id='choice_19_45_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_45_5' id='label_19_45_5' class='gform-field-label gform-field-label--type-inline'>E-learning; unlimited online practice with an individual language package<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_19_45'>All teaching packages exclude teaching materials, and administration fees (total: approx. \u20ac125)\nExplanation and prices at www. \n<\/div><\/li><li id=\"field_19_93\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_93'><span class='gform-field-label__text'>In case of language training: which language do you want to learn\/improve (target language)?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_93' id='input_19_93' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_3\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Title:<\/span><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_19_3'><li class='gchoice gchoice_19_3_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_3.1' type='checkbox'  value='Mr.'  id='choice_19_3_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_3_1' id='label_19_3_1' class='gform-field-label gform-field-label--type-inline'>Mr.<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_3_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_3.2' type='checkbox'  value='Ms.'  id='choice_19_3_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_3_2' id='label_19_3_2' class='gform-field-label gform-field-label--type-inline'>Ms.<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_4\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_4'><span class='gform-field-label__text'>Name and surname:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_19_4' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_17\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address gform-grid-row' id='input_19_17' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_19_17_1_container' >\n                                        <input type='text' name='input_17.1' id='input_19_17_1' value=''    aria-required='true'    \/>\n                                        <label for='input_19_17_1' id='input_19_17_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_19_17_3_container' >\n                                    <input type='text' name='input_17.3' id='input_19_17_3' value=''    aria-required='true'    \/>\n                                    <label for='input_19_17_3' id='input_19_17_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_19_17_4_container' >\n                                        <input type='text' name='input_17.4' id='input_19_17_4' value=''      aria-required='true'    \/>\n                                        <label for='input_19_17_4' id='input_19_17_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_19_17_5_container' >\n                                    <input type='text' name='input_17.5' id='input_19_17_5' value=''    aria-required='true'    \/>\n                                    <label for='input_19_17_5' id='input_19_17_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_17.6' id='input_19_17_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_19_52\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_52'><span class='gform-field-label__text'>1. What is your current occupation\/job: (or last enjoyed occupation\/job)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_52' id='input_19_52' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_69\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_69'><span class='gform-field-label__text'>2. What is your general (prior) education:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_69' id='input_19_69' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_8\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_8'><span class='gform-field-label__text'>E-mail:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_19_8' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_58\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-international gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_58'><span class='gform-field-label__text'>Phone number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_58' id='input_19_58' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"    \/><\/div><\/li><li id=\"field_19_10\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_10'><span class='gform-field-label__text'>Today&#039;s date<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='dd-mm-yyyy'\n\t\t\t\t\tid='input_19_10'\n\t\t\t\t\tclass='datepicker gform-datepicker dmy_dash datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_10'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\taria-required=\"true\"\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99-99-9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_19_10' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_19_10' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_19_10' aria-label='Today's date: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/li><li id=\"field_19_114\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_114'><span class='gform-field-label__text'>Date of birth:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='dd-mm-yyyy'\n\t\t\t\t\tid='input_19_114'\n\t\t\t\t\tclass='datepicker gform-datepicker dmy_dash datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_114'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\taria-required=\"true\"\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99-99-9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_19_114' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_19_114' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_19_114' aria-label='Date of birth:: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/li><li id=\"field_19_11\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_11'><span class='gform-field-label__text'>Nationality:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_19_11' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_12\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_12'><span class='gform-field-label__text'>Mother tongue:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_19_12' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <button type='button' id='gform_next_button_19_119' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_19_2' class='gform_page' data-js='page-field-id-119' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_19_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_19_70\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_70'><span class='gform-field-label__text'>3. How do you learn most effectively? (visually, aurally or by other means) <\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_70' id='input_19_70' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_90\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Specific concerns:<\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_19_90'><li class='gchoice gchoice_19_90_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_90.1' type='checkbox'  value='Dyslexia'  id='choice_19_90_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_90_1' id='label_19_90_1' class='gform-field-label gform-field-label--type-inline'>Dyslexia<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_90_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_90.2' type='checkbox'  value='Hearing problems'  id='choice_19_90_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_90_2' id='label_19_90_2' class='gform-field-label gform-field-label--type-inline'>Hearing problems<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_90_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_90.3' type='checkbox'  value='Speech Problems'  id='choice_19_90_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_90_3' id='label_19_90_3' class='gform-field-label gform-field-label--type-inline'>Speech Problems<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_90_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_90.4' type='checkbox'  value='Visually impaired'  id='choice_19_90_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_90_4' id='label_19_90_4' class='gform-field-label gform-field-label--type-inline'>Visually impaired<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_71\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_71'><span class='gform-field-label__text'>4. What connection do you have privately with target language ? (vacations, relationship, work, TV, reading magazines\/books) <\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_71' id='input_19_71' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_72\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>5. Do you have any personal materials (letters, memos, accomplishments, etc.) that could give the trainer a picture of your work and that you could work with during the training ? If so, can you send or bring them ? <\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_19_72'><li class='gchoice gchoice_19_72_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_72.1' type='checkbox'  value='yes'  id='choice_19_72_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_72_1' id='label_19_72_1' class='gform-field-label gform-field-label--type-inline'>yes<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_72_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_72.2' type='checkbox'  value='no'  id='choice_19_72_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_72_2' id='label_19_72_2' class='gform-field-label gform-field-label--type-inline'>no<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_72_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_72.3' type='checkbox'  value='N\/A.'  id='choice_19_72_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_72_3' id='label_19_72_3' class='gform-field-label gform-field-label--type-inline'>N\/A.<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_15\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_15'><span class='gform-field-label__text'>Company name:<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_15' id='input_19_15' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_18\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_18'><span class='gform-field-label__text'>Name and last name supervisor:<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_18' id='input_19_18' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_19\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_19'><span class='gform-field-label__text'>Leading phone number:<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_19_19' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_20\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_20'><span class='gform-field-label__text'>Email executive:<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_20' id='input_19_20' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_16\" class=\"gfield gfield--type-address gfield--input-type-address field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Company address<\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address gform-grid-row' id='input_19_16' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_19_16_1_container' >\n                                        <input type='text' name='input_16.1' id='input_19_16_1' value=''    aria-required='false'    \/>\n                                        <label for='input_19_16_1' id='input_19_16_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_19_16_3_container' >\n                                    <input type='text' name='input_16.3' id='input_19_16_3' value=''    aria-required='false'    \/>\n                                    <label for='input_19_16_3' id='input_19_16_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_19_16_4_container' >\n                                        <input type='text' name='input_16.4' id='input_19_16_4' value=''      aria-required='false'    \/>\n                                        <label for='input_19_16_4' id='input_19_16_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_19_16_5_container' >\n                                    <input type='text' name='input_16.5' id='input_19_16_5' value=''    aria-required='false'    \/>\n                                    <label for='input_19_16_5' id='input_19_16_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_16.6' id='input_19_16_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_19_120' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Previous<\/button> <button type='button' id='gform_next_button_19_120' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_19_3' class='gform_page' data-js='page-field-id-120' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_19_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_19_94\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_94'><span class='gform-field-label__text'>A1. If applicable, how long have you lived in the Netherlands? <\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_94' id='input_19_94' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_23\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>A2: Language question: Have you taken classes in the target language before? For communication training or career pathways, scroll down! (To PART C)  <\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_19_23'><li class='gchoice gchoice_19_23_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.1' type='checkbox'  value='Yes'  id='choice_19_23_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_23_1' id='label_19_23_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_23_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.2' type='checkbox'  value='No'  id='choice_19_23_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_23_2' id='label_19_23_2' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_25\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_25'><span class='gform-field-label__text'>A3. If so, what year was this? <\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_25' id='input_19_25' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_47\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>A4. Estimation of your starting level: <\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_19_47'><li class='gchoice gchoice_19_47_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.1' type='checkbox'  value='A1 Starter'  id='choice_19_47_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_47_1' id='label_19_47_1' class='gform-field-label gform-field-label--type-inline'>A1 Starter<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_47_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.2' type='checkbox'  value='A2 Beginner'  id='choice_19_47_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_47_2' id='label_19_47_2' class='gform-field-label gform-field-label--type-inline'>A2 Beginner<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_47_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.3' type='checkbox'  value='B1 Semi-advanced'  id='choice_19_47_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_47_3' id='label_19_47_3' class='gform-field-label gform-field-label--type-inline'>B1 Semi-advanced<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_47_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.4' type='checkbox'  value='B2 Advanced'  id='choice_19_47_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_47_4' id='label_19_47_4' class='gform-field-label gform-field-label--type-inline'>B2 Advanced<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_47_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.5' type='checkbox'  value='C1 Advanced'  id='choice_19_47_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_47_5' id='label_19_47_5' class='gform-field-label gform-field-label--type-inline'>C1 Advanced<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_112\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>What is your target level?<\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_19_112'><li class='gchoice gchoice_19_112_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_112.1' type='checkbox'  value='A1 Starter'  id='choice_19_112_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_112_1' id='label_19_112_1' class='gform-field-label gform-field-label--type-inline'>A1 Starter<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_112_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_112.2' type='checkbox'  value='A2 Beginner'  id='choice_19_112_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_112_2' id='label_19_112_2' class='gform-field-label gform-field-label--type-inline'>A2 Beginner<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_112_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_112.3' type='checkbox'  value='B1 Semi-advanced'  id='choice_19_112_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_112_3' id='label_19_112_3' class='gform-field-label gform-field-label--type-inline'>B1 Semi-advanced<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_112_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_112.4' type='checkbox'  value='B2 Advanced'  id='choice_19_112_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_112_4' id='label_19_112_4' class='gform-field-label gform-field-label--type-inline'>B2 Advanced<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_112_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_112.5' type='checkbox'  value='C1 Advanced'  id='choice_19_112_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_112_5' id='label_19_112_5' class='gform-field-label gform-field-label--type-inline'>C1 Advanced<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_24\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>A5. Do you have practical experience with the target language? <\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_19_24'><li class='gchoice gchoice_19_24_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.1' type='checkbox'  value='Yes'  id='choice_19_24_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_24_1' id='label_19_24_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_24_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.2' type='checkbox'  value='No'  id='choice_19_24_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_24_2' id='label_19_24_2' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_26\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>A6. What do you want to use this language primarily for? <\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_19_26'><li class='gchoice gchoice_19_26_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.1' type='checkbox'  value='Work (Development in current work)'  id='choice_19_26_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_26_1' id='label_19_26_1' class='gform-field-label gform-field-label--type-inline'>Work (Development in current work)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_26_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.2' type='checkbox'  value='Work (Job retention)'  id='choice_19_26_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_26_2' id='label_19_26_2' class='gform-field-label gform-field-label--type-inline'>Work (Job retention)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_26_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.3' type='checkbox'  value='Employment (more likely to be employed)'  id='choice_19_26_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_26_3' id='label_19_26_3' class='gform-field-label gform-field-label--type-inline'>Employment (more likely to be employed)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_26_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.4' type='checkbox'  value='Private'  id='choice_19_26_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_26_4' id='label_19_26_4' class='gform-field-label gform-field-label--type-inline'>Private<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_26_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.5' type='checkbox'  value='Work and home'  id='choice_19_26_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_26_5' id='label_19_26_5' class='gform-field-label gform-field-label--type-inline'>Work and home<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_42\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_42'><span class='gform-field-label__text'>A7. Describe (for DOEL language training) why it is important for you to learn this language and what your learning goals\/expectations are: <\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_42' id='input_19_42' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_29\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Part B: B1. Implementation and Content. When do you want to start the training?  <\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_19_29'><li class='gchoice gchoice_19_29_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_29.1' type='checkbox'  value='As soon as possible'  id='choice_19_29_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_29_1' id='label_19_29_1' class='gform-field-label gform-field-label--type-inline'>As soon as possible<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_29_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_29.2' type='checkbox'  value='By arrangement'  id='choice_19_29_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_29_2' id='label_19_29_2' class='gform-field-label gform-field-label--type-inline'>By arrangement<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_29_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_29.3' type='checkbox'  value='Otherwise'  id='choice_19_29_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_29_3' id='label_19_29_3' class='gform-field-label gform-field-label--type-inline'>Otherwise<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_30\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_30'><span class='gform-field-label__text'>B2. How many times a week would you like to have lessons? <\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_30' id='input_19_30' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_111\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>B3. Preferred location <\/span><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_19_111'><li class='gchoice gchoice_19_111_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_111.1' type='checkbox'  value='Bogaers Language Institute'  id='choice_19_111_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_111_1' id='label_19_111_1' class='gform-field-label gform-field-label--type-inline'>Bogaers Language Institute<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_111_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_111.2' type='checkbox'  value='On site'  id='choice_19_111_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_111_2' id='label_19_111_2' class='gform-field-label gform-field-label--type-inline'>On site<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_87\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_87'><span class='gform-field-label__text'>B4. How much study time are you willing\/able to invest? (recommendation 30 min.) per day  <\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_87' id='input_19_87' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_19_121' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Previous<\/button> <button type='button' id='gform_next_button_19_121' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_19_4' class='gform_page' data-js='page-field-id-121' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_19_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_19_53\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_53'><span class='gform-field-label__text'>Preferred class days<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_53' id='input_19_53' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_56\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_56'><span class='gform-field-label__text'>NO lesson on:<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_56' id='input_19_56' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_54\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_54'><span class='gform-field-label__text'>Preferred class times<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_54' id='input_19_54' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_89\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_89'><span class='gform-field-label__text'>Preferred interim contact moments with relationship management Bogaers?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_89' id='input_19_89' type='text' value='' class='large'  aria-describedby=\"gfield_description_19_89\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_19_89'>Usually 1-2 times per track\n(Reports are also sent to employer)<\/div><\/li><li id=\"field_19_49\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>B5. Do you prefer an individual customized package for specific needs or general group classes? <\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_19_49'><li class='gchoice gchoice_19_49_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.1' type='checkbox'  value='Company Training (customized)'  id='choice_19_49_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_49_1' id='label_19_49_1' class='gform-field-label gform-field-label--type-inline'>Company Training (customized)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_49_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.2' type='checkbox'  value='Individual Customized Training'  id='choice_19_49_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_49_2' id='label_19_49_2' class='gform-field-label gform-field-label--type-inline'>Individual Customized Training<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_49_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.3' type='checkbox'  value='Emergency Training (customized)'  id='choice_19_49_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_49_3' id='label_19_49_3' class='gform-field-label gform-field-label--type-inline'>Emergency Training (customized)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_49_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.4' type='checkbox'  value='Blended Learning (customization)'  id='choice_19_49_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_49_4' id='label_19_49_4' class='gform-field-label gform-field-label--type-inline'>Blended Learning (customization)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_49_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.5' type='checkbox'  value='Dutch As a Second Language (Inburgering)'  id='choice_19_49_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_49_5' id='label_19_49_5' class='gform-field-label gform-field-label--type-inline'>Dutch As a Second Language (Inburgering)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_49_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.6' type='checkbox'  value='General Open Group Training'  id='choice_19_49_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_49_6' id='label_19_49_6' class='gform-field-label gform-field-label--type-inline'>General Open Group Training<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_40\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>B6. Are you open to taking online assignments and thus a higher yield of extra practice (WITHOUT DOCENT)? <\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_19_40'><li class='gchoice gchoice_19_40_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.1' type='checkbox'  value='Not interested'  id='choice_19_40_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_40_1' id='label_19_40_1' class='gform-field-label gform-field-label--type-inline'>Not interested<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_40_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.2' type='checkbox'  value='Online with e-learning'  id='choice_19_40_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_40_2' id='label_19_40_2' class='gform-field-label gform-field-label--type-inline'>Online with e-learning<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_41\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>B7. Is there a maximum budget? <\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_19_41'><li class='gchoice gchoice_19_41_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.1' type='checkbox'  value='Yes'  id='choice_19_41_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_41_1' id='label_19_41_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_41_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.2' type='checkbox'  value='No'  id='choice_19_41_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_41_2' id='label_19_41_2' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_106\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>B8. How did you find Bogaers? <\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_19_106'>\n\t\t\t<li class='gchoice gchoice_19_106_0'>\n\t\t\t\t<input name='input_106' type='radio' value='Internet'  id='choice_19_106_0'    \/>\n\t\t\t\t<label for='choice_19_106_0' id='label_19_106_0' class='gform-field-label gform-field-label--type-inline'>Internet<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_106_1'>\n\t\t\t\t<input name='input_106' type='radio' value='Advertisement'  id='choice_19_106_1'    \/>\n\t\t\t\t<label for='choice_19_106_1' id='label_19_106_1' class='gform-field-label gform-field-label--type-inline'>Advertisement<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_106_2'>\n\t\t\t\t<input name='input_106' type='radio' value='Via via'  id='choice_19_106_2'    \/>\n\t\t\t\t<label for='choice_19_106_2' id='label_19_106_2' class='gform-field-label gform-field-label--type-inline'>Via via<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_106_3'>\n\t\t\t\t<input name='input_106' type='radio' value='Former student'  id='choice_19_106_3'    \/>\n\t\t\t\t<label for='choice_19_106_3' id='label_19_106_3' class='gform-field-label gform-field-label--type-inline'>Former student<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_106_4'>\n\t\t\t\t<input name='input_106' type='radio' value='gf_other_choice'  id='choice_19_106_4'   onfocus=\"jQuery(this).next('input').focus();\" \/>\n\t\t\t\t<input class='small' id='input_19_106_other' name='input_106_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><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_19_122' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Previous<\/button> <button type='button' id='gform_next_button_19_122' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_19_5' class='gform_page' data-js='page-field-id-122' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_19_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_19_43\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Beginning test only if desired and\/or taken, I do not pay registration \u20ac50,-. If I do register &#8211; within 2 weeks &#8211; the test costs will NOT be invoiced. <\/span><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_19_43'><li class='gchoice gchoice_19_43_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.1' type='checkbox'  value='I indicate that I am aware of this and agree to the test.'  id='choice_19_43_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_43_1' id='label_19_43_1' class='gform-field-label gform-field-label--type-inline'>I indicate that I am aware of this and agree to the test.<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_43_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.2' type='checkbox'  value='I state that I am aware of this, but I do not agree to the test at this time.'  id='choice_19_43_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_43_2' id='label_19_43_2' class='gform-field-label gform-field-label--type-inline'>I state that I am aware of this, but I do not agree to the test at this time.<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_100\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Final Test: My teacher will set it up for me some time BEFORE the last class. The final result of the final test will appear on my certificate; along with the teacher&#039;s findings. The cost for the final test is \u20ac50.  <\/span><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_19_100'><li class='gchoice gchoice_19_100_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_100.1' type='checkbox'  value='I indicate that I am aware of this and agree to the final test.'  id='choice_19_100_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_100_1' id='label_19_100_1' class='gform-field-label gform-field-label--type-inline'>I indicate that I am aware of this and agree to the final test.<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_100_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_100.2' type='checkbox'  value='I indicate that I am aware of this, but I do not agree to the final test at this time.'  id='choice_19_100_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_100_2' id='label_19_100_2' class='gform-field-label gform-field-label--type-inline'>I indicate that I am aware of this, but I do not agree to the final test at this time.<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_81\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>CONTENT: Reading: Check only those learning requirements that contribute to the achievement of the objective and are achievable within the desired number of hours:<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_19_81'>\n\t\t\t<li class='gchoice gchoice_19_81_0'>\n\t\t\t\t<input name='input_81' type='radio' value='Recognize simple words and phrases in e.g. Emails, forms, schedules, menus, captions, newspaper headlines, etc. (A1) '  id='choice_19_81_0'    \/>\n\t\t\t\t<label for='choice_19_81_0' id='label_19_81_0' class='gform-field-label gform-field-label--type-inline'>Recognize simple words and phrases in e.g. Emails, forms, schedules, menus, captions, newspaper headlines, etc. (A1) <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_81_1'>\n\t\t\t\t<input name='input_81' type='radio' value='Understand the essence of brochures, emails, newsletters, advertisements, etc. (A2)'  id='choice_19_81_1'    \/>\n\t\t\t\t<label for='choice_19_81_1' id='label_19_81_1' class='gform-field-label gform-field-label--type-inline'>Understand the essence of brochures, emails, newsletters, advertisements, etc. (A2)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_81_2'>\n\t\t\t\t<input name='input_81' type='radio' value='Understand simple, clearly written work instructions. (A2) '  id='choice_19_81_2'    \/>\n\t\t\t\t<label for='choice_19_81_2' id='label_19_81_2' class='gform-field-label gform-field-label--type-inline'>Understand simple, clearly written work instructions. (A2) <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_81_3'>\n\t\t\t\t<input name='input_81' type='radio' value='Understand the essence and important details of reports, brochures, business and private correspondence, manuals, etc. (B1)'  id='choice_19_81_3'    \/>\n\t\t\t\t<label for='choice_19_81_3' id='label_19_81_3' class='gform-field-label gform-field-label--type-inline'>Understand the essence and important details of reports, brochures, business and private correspondence, manuals, etc. (B1)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_81_4'>\n\t\t\t\t<input name='input_81' type='radio' value='Understand in detail general and technical articles, reports, etc. (B2) '  id='choice_19_81_4'    \/>\n\t\t\t\t<label for='choice_19_81_4' id='label_19_81_4' class='gform-field-label gform-field-label--type-inline'>Understand in detail general and technical articles, reports, etc. (B2) <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_81_5'>\n\t\t\t\t<input name='input_81' type='radio' value='Read a variety of business and non-business texts at an acceptable pace. (B2) '  id='choice_19_81_5'    \/>\n\t\t\t\t<label for='choice_19_81_5' id='label_19_81_5' class='gform-field-label gform-field-label--type-inline'>Read a variety of business and non-business texts at an acceptable pace. (B2) <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_81_6'>\n\t\t\t\t<input name='input_81' type='radio' value='Understand long, specialized articles and technical treatises. (C1) '  id='choice_19_81_6'    \/>\n\t\t\t\t<label for='choice_19_81_6' id='label_19_81_6' class='gform-field-label gform-field-label--type-inline'>Understand long, specialized articles and technical treatises. (C1) <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_81_7'>\n\t\t\t\t<input name='input_81' type='radio' value='Understand virtually all forms of written text without extra effort. (C2) '  id='choice_19_81_7'    \/>\n\t\t\t\t<label for='choice_19_81_7' id='label_19_81_7' class='gform-field-label gform-field-label--type-inline'>Understand virtually all forms of written text without extra effort. (C2) <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_81_8'>\n\t\t\t\t<input name='input_81' type='radio' value='Other Nl. ...... '  id='choice_19_81_8'    \/>\n\t\t\t\t<label for='choice_19_81_8' id='label_19_81_8' class='gform-field-label gform-field-label--type-inline'>Other Nl. &#8230;&#8230; <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_81_9'>\n\t\t\t\t<input name='input_81' type='radio' value='gf_other_choice'  id='choice_19_81_9'   onfocus=\"jQuery(this).next('input').focus();\" \/>\n\t\t\t\t<input class='small' id='input_19_81_other' name='input_81_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_19_82\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Listening Skills: tick only those learning requirements that contribute to the achievement of the objective and are achievable within the desired number of hours:<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_19_82'>\n\t\t\t<li class='gchoice gchoice_19_82_0'>\n\t\t\t\t<input name='input_82' type='radio' value='Understand instructions, requests and communications in familiar situations. (A1) '  id='choice_19_82_0'    \/>\n\t\t\t\t<label for='choice_19_82_0' id='label_19_82_0' class='gform-field-label gform-field-label--type-inline'>Understand instructions, requests and communications in familiar situations. (A1) <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_82_1'>\n\t\t\t\t<input name='input_82' type='radio' value='Understand the main points and some details in spontaneous conversations on familiar topics. (A2) '  id='choice_19_82_1'    \/>\n\t\t\t\t<label for='choice_19_82_1' id='label_19_82_1' class='gform-field-label gform-field-label--type-inline'>Understand the main points and some details in spontaneous conversations on familiar topics. (A2) <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_82_2'>\n\t\t\t\t<input name='input_82' type='radio' value='Understand the essentials of spoken language on everyday and occupational topics B1'  id='choice_19_82_2'    \/>\n\t\t\t\t<label for='choice_19_82_2' id='label_19_82_2' class='gform-field-label gform-field-label--type-inline'>Understand the essentials of spoken language on everyday and occupational topics B1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_82_3'>\n\t\t\t\t<input name='input_82' type='radio' value='Understand in detail spoken language on everyday and occupational topics. (B2) '  id='choice_19_82_3'    \/>\n\t\t\t\t<label for='choice_19_82_3' id='label_19_82_3' class='gform-field-label gform-field-label--type-inline'>Understand in detail spoken language on everyday and occupational topics. (B2) <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_82_4'>\n\t\t\t\t<input name='input_82' type='radio' value='Follow complex reasoning and discussions during meetings, for example. (B2) '  id='choice_19_82_4'    \/>\n\t\t\t\t<label for='choice_19_82_4' id='label_19_82_4' class='gform-field-label gform-field-label--type-inline'>Follow complex reasoning and discussions during meetings, for example. (B2) <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_82_5'>\n\t\t\t\t<input name='input_82' type='radio' value='Recognize idiomatic expressions and understand the nuances of spoken language. (C1) '  id='choice_19_82_5'    \/>\n\t\t\t\t<label for='choice_19_82_5' id='label_19_82_5' class='gform-field-label gform-field-label--type-inline'>Recognize idiomatic expressions and understand the nuances of spoken language. (C1) <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_82_6'>\n\t\t\t\t<input name='input_82' type='radio' value='Understand and comprehend virtually all spoken texts without additional effort. (C2) '  id='choice_19_82_6'    \/>\n\t\t\t\t<label for='choice_19_82_6' id='label_19_82_6' class='gform-field-label gform-field-label--type-inline'>Understand and comprehend virtually all spoken texts without additional effort. (C2) <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_82_7'>\n\t\t\t\t<input name='input_82' type='radio' value='Other Nl. ...... '  id='choice_19_82_7'    \/>\n\t\t\t\t<label for='choice_19_82_7' id='label_19_82_7' class='gform-field-label gform-field-label--type-inline'>Other Nl. &#8230;&#8230; <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_82_8'>\n\t\t\t\t<input name='input_82' type='radio' value='gf_other_choice'  id='choice_19_82_8'   onfocus=\"jQuery(this).next('input').focus();\" \/>\n\t\t\t\t<input class='small' id='input_19_82_other' name='input_82_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_19_83\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Conversations: Tick only those learning desires that contribute to achievement and are achievable within the desired number of hours:<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_19_83'>\n\t\t\t<li class='gchoice gchoice_19_83_0'>\n\t\t\t\t<input name='input_83' type='radio' value='Provide personal information, ask and answer routine questions. (A1) '  id='choice_19_83_0'    \/>\n\t\t\t\t<label for='choice_19_83_0' id='label_19_83_0' class='gform-field-label gform-field-label--type-inline'>Provide personal information, ask and answer routine questions. (A1) <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_83_1'>\n\t\t\t\t<input name='input_83' type='radio' value='Have a short conversation about business everyday issues. (A2) '  id='choice_19_83_1'    \/>\n\t\t\t\t<label for='choice_19_83_1' id='label_19_83_1' class='gform-field-label gform-field-label--type-inline'>Have a short conversation about business everyday issues. (A2) <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_83_2'>\n\t\t\t\t<input name='input_83' type='radio' value='Conduct a standard telephone conversation in accordance with established conventions. (A2) '  id='choice_19_83_2'    \/>\n\t\t\t\t<label for='choice_19_83_2' id='label_19_83_2' class='gform-field-label gform-field-label--type-inline'>Conduct a standard telephone conversation in accordance with established conventions. (A2) <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_83_3'>\n\t\t\t\t<input name='input_83' type='radio' value='Unprepared to establish and maintain social and occupational contacts. (B1) '  id='choice_19_83_3'    \/>\n\t\t\t\t<label for='choice_19_83_3' id='label_19_83_3' class='gform-field-label gform-field-label--type-inline'>Unprepared to establish and maintain social and occupational contacts. (B1) <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_83_4'>\n\t\t\t\t<input name='input_83' type='radio' value='Lead discussions about one&#039;s own field or beyond. (B2) '  id='choice_19_83_4'    \/>\n\t\t\t\t<label for='choice_19_83_4' id='label_19_83_4' class='gform-field-label gform-field-label--type-inline'>Lead discussions about one&#8217;s own field or beyond. (B2) <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_83_5'>\n\t\t\t\t<input name='input_83' type='radio' value='giving explanations and instructions. (B2) '  id='choice_19_83_5'    \/>\n\t\t\t\t<label for='choice_19_83_5' id='label_19_83_5' class='gform-field-label gform-field-label--type-inline'>giving explanations and instructions. (B2) <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_83_6'>\n\t\t\t\t<input name='input_83' type='radio' value='Know how to express oneself reasonably well and generally correctly when: meeting (C1)'  id='choice_19_83_6'    \/>\n\t\t\t\t<label for='choice_19_83_6' id='label_19_83_6' class='gform-field-label gform-field-label--type-inline'>Know how to express oneself reasonably well and generally correctly when: meeting (C1)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_83_7'>\n\t\t\t\t<input name='input_83' type='radio' value='participating in a training\/workshop'  id='choice_19_83_7'    \/>\n\t\t\t\t<label for='choice_19_83_7' id='label_19_83_7' class='gform-field-label gform-field-label--type-inline'>participating in a training\/workshop<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_83_8'>\n\t\t\t\t<input name='input_83' type='radio' value='negotiate'  id='choice_19_83_8'    \/>\n\t\t\t\t<label for='choice_19_83_8' id='label_19_83_8' class='gform-field-label gform-field-label--type-inline'>negotiate<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_83_9'>\n\t\t\t\t<input name='input_83' type='radio' value='express his\/her thoughts spontaneously and precisely, using idiomatic expressions C2'  id='choice_19_83_9'    \/>\n\t\t\t\t<label for='choice_19_83_9' id='label_19_83_9' class='gform-field-label gform-field-label--type-inline'>express his\/her thoughts spontaneously and precisely, using idiomatic expressions C2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_83_10'>\n\t\t\t\t<input name='input_83' type='radio' value='gf_other_choice'  id='choice_19_83_10'   onfocus=\"jQuery(this).next('input').focus();\" \/>\n\t\t\t\t<input class='small' id='input_19_83_other' name='input_83_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_19_84\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Public Speaking: Check only those learning requirements that contribute to the achievement of the objective and are achievable within the desired number of hours:<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_19_84'>\n\t\t\t<li class='gchoice gchoice_19_84_0'>\n\t\t\t\t<input name='input_84' type='radio' value='Briefly tell something about background, family situation, employment history, etc. (A2)'  id='choice_19_84_0'    \/>\n\t\t\t\t<label for='choice_19_84_0' id='label_19_84_0' class='gform-field-label gform-field-label--type-inline'>Briefly tell something about background, family situation, employment history, etc. (A2)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_84_1'>\n\t\t\t\t<input name='input_84' type='radio' value='Briefly report and explain opinions and plans. (B1) '  id='choice_19_84_1'    \/>\n\t\t\t\t<label for='choice_19_84_1' id='label_19_84_1' class='gform-field-label gform-field-label--type-inline'>Briefly report and explain opinions and plans. (B1) <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_84_2'>\n\t\t\t\t<input name='input_84' type='radio' value='Clearly and in detail describe projects, proposals processes. (B2) '  id='choice_19_84_2'    \/>\n\t\t\t\t<label for='choice_19_84_2' id='label_19_84_2' class='gform-field-label gform-field-label--type-inline'>Clearly and in detail describe projects, proposals processes. (B2) <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_84_3'>\n\t\t\t\t<input name='input_84' type='radio' value='Know how to express themselves reasonably well and generally correctly when: \u25a1 chairing meetings \u25a1 participating in training\/workshops \u25a1 negotiating (C1)'  id='choice_19_84_3'    \/>\n\t\t\t\t<label for='choice_19_84_3' id='label_19_84_3' class='gform-field-label gform-field-label--type-inline'>Know how to express themselves reasonably well and generally correctly when: \u25a1 chairing meetings \u25a1 participating in training\/workshops \u25a1 negotiating (C1)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_84_4'>\n\t\t\t\t<input name='input_84' type='radio' value='gf_other_choice'  id='choice_19_84_4'   onfocus=\"jQuery(this).next('input').focus();\" \/>\n\t\t\t\t<input class='small' id='input_19_84_other' name='input_84_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_19_85\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Writing: Check only those learning requirements that contribute to achievement and are achievable within the desired number of hours:<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_19_85'>\n\t\t\t<li class='gchoice gchoice_19_85_0'>\n\t\t\t\t<input name='input_85' type='radio' value='Fill in personal information on standard forms. (A1) '  id='choice_19_85_0'    \/>\n\t\t\t\t<label for='choice_19_85_0' id='label_19_85_0' class='gform-field-label gform-field-label--type-inline'>Fill in personal information on standard forms. (A1) <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_85_1'>\n\t\t\t\t<input name='input_85' type='radio' value='Write short announcements and take notes, e.g., during a telephone conversation. (A2) '  id='choice_19_85_1'    \/>\n\t\t\t\t<label for='choice_19_85_1' id='label_19_85_1' class='gform-field-label gform-field-label--type-inline'>Write short announcements and take notes, e.g., during a telephone conversation. (A2) <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_85_2'>\n\t\t\t\t<input name='input_85' type='radio' value='Routinely write letters, e-mails and faxes. (B1) '  id='choice_19_85_2'    \/>\n\t\t\t\t<label for='choice_19_85_2' id='label_19_85_2' class='gform-field-label gform-field-label--type-inline'>Routinely write letters, e-mails and faxes. (B1) <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_85_3'>\n\t\t\t\t<input name='input_85' type='radio' value='Drafting and writing, more or less correctly, \u25a1 business letters \u25a1 reports \u25a1 reports \u25a1 actions \u25a1 proposals \u25a1 minutes (B2)'  id='choice_19_85_3'    \/>\n\t\t\t\t<label for='choice_19_85_3' id='label_19_85_3' class='gform-field-label gform-field-label--type-inline'>Drafting and writing, more or less correctly, \u25a1 business letters \u25a1 reports \u25a1 reports \u25a1 actions \u25a1 proposals \u25a1 minutes (B2)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_85_4'>\n\t\t\t\t<input name='input_85' type='radio' value='Compose a variety of business and non-business texts at an acceptable pace. (B2) '  id='choice_19_85_4'    \/>\n\t\t\t\t<label for='choice_19_85_4' id='label_19_85_4' class='gform-field-label gform-field-label--type-inline'>Compose a variety of business and non-business texts at an acceptable pace. (B2) <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_85_5'>\n\t\t\t\t<input name='input_85' type='radio' value='Drafting and writing, with a high degree of correctness, \u25a1 business letters \u25a1 reports \u25a1 proceedings \u25a1 proposals \u25a1 minutes (C1)'  id='choice_19_85_5'    \/>\n\t\t\t\t<label for='choice_19_85_5' id='label_19_85_5' class='gform-field-label gform-field-label--type-inline'>Drafting and writing, with a high degree of correctness, \u25a1 business letters \u25a1 reports \u25a1 proceedings \u25a1 proposals \u25a1 minutes (C1)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_85_6'>\n\t\t\t\t<input name='input_85' type='radio' value='Independently and nearly flawlessly produce a well-paced, structured text on a complex topic. (C2) '  id='choice_19_85_6'    \/>\n\t\t\t\t<label for='choice_19_85_6' id='label_19_85_6' class='gform-field-label gform-field-label--type-inline'>Independently and nearly flawlessly produce a well-paced, structured text on a complex topic. (C2) <\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_85_7'>\n\t\t\t\t<input name='input_85' type='radio' value='gf_other_choice'  id='choice_19_85_7'   onfocus=\"jQuery(this).next('input').focus();\" \/>\n\t\t\t\t<input class='small' id='input_19_85_other' name='input_85_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_19_65\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Part C: COMMUNICATION TRAINING; Under communication training you will find our additional learning modules. Please indicate your learning objectives here: <\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_19_65'><li class='gchoice gchoice_19_65_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_65.1' type='checkbox'  value='Learning to Present'  id='choice_19_65_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_65_1' id='label_19_65_1' class='gform-field-label gform-field-label--type-inline'>Learning to Present<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_65_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_65.2' type='checkbox'  value='Recruiting Writing'  id='choice_19_65_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_65_2' id='label_19_65_2' class='gform-field-label gform-field-label--type-inline'>Recruiting Writing<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_65_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_65.3' type='checkbox'  value='Flawless Dutch Speaking and Writing'  id='choice_19_65_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_65_3' id='label_19_65_3' class='gform-field-label gform-field-label--type-inline'>Flawless Dutch Speaking and Writing<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_107\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Desired tests<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_19_107'>\n\t\t\t<li class='gchoice gchoice_19_107_0'>\n\t\t\t\t<input name='input_107' type='radio' value='Learnability test'  id='choice_19_107_0'    \/>\n\t\t\t\t<label for='choice_19_107_0' id='label_19_107_0' class='gform-field-label gform-field-label--type-inline'>Learnability test<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_107_1'>\n\t\t\t\t<input name='input_107' type='radio' value='Learning Style Test'  id='choice_19_107_1'    \/>\n\t\t\t\t<label for='choice_19_107_1' id='label_19_107_1' class='gform-field-label gform-field-label--type-inline'>Learning Style Test<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_107_2'>\n\t\t\t\t<input name='input_107' type='radio' value='Language test for level determination'  id='choice_19_107_2'    \/>\n\t\t\t\t<label for='choice_19_107_2' id='label_19_107_2' class='gform-field-label gform-field-label--type-inline'>Language test for level determination<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_51\" class=\"gfield gfield--type-textarea gfield--input-type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_51'><span class='gform-field-label__text'>Comments<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_51' id='input_19_51' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_19_57\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_57'><span class='gform-field-label__text'>Privacy<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_57' id='input_19_57' type='text' value='' class='medium'  aria-describedby=\"gfield_description_19_57\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_19_57'>Bogaers Taleninstituut BV, Groenstraat 139-155 Tilburg or one of its affiliated companies will treat students&#8217; data in accordance with the Personal Data Protection Act. They may use this data for the commercial promotion of their products and services. The student has the right to inspect the data relating to him or her and, if necessary, can request its rectification.  <\/div><\/li><li id=\"field_19_44\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>General conditions<\/span><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_19_44'><li class='gchoice gchoice_19_44_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.1' type='checkbox'  value='I agree to the &lt;a href=&quot;\/wp-content\/uploads\/2015\/09\/Algemene-Voorwaarden-2015.pdf&quot;&gt;Terms and Conditions&lt;\/a&gt;'  id='choice_19_44_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_44_1' id='label_19_44_1' class='gform-field-label gform-field-label--type-inline'>I agree to the <a href=\"\/wp-content\/uploads\/2015\/09\/Algemene-Voorwaarden-2015.pdf\">Terms and Conditions<\/a><\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_60\" class=\"gfield gfield--type-signature gfield--input-type-signature field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_60'><span class='gform-field-label__text'>Signature<\/span><\/label><div class=\"ginput_container ginput_container_signature\"><input type='hidden' value='' name='input_60' id='input_19_60_signature_filename' class='gfield_signature_filename'\/><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_19_60_Container' class='gfield_signature_container' style='height:90px; width:300px; ' ><input type='hidden' id='input_19_60_data' name='input_19_60_data' class='gfield_signature_data' \/><canvas id=\"input_19_60\" width=\"300\" height=\"90\" style=\"border-style: Dashed; border-width: 2px; border-color: #757575; background-color:#FFFFFF; cursor: url(https:\/\/www.bogaerstalen.nl\/wp-content\/plugins\/gravityformssignature\/assets\/img\/pen.cur), pointer;\" tabindex=\"0\" aria-label=\"Signature pad\" ><\/canvas><input type='text' id='input_19_60_textinput' name='input_19_60_textinput' class='gfield_signature_text_input' style='text-indent:10px;display:none;width:300px;height:90px;border-style:Dashed;border-width:2px;border-color:#757575;background-color:#FFFFFF;font-family:&quot;Snell Roundhand&quot;, &quot;Segoe Script&quot;, cursive;font-size:2em;padding:0 12px;box-sizing:border-box;color:#000000;' placeholder='Type your signature' autocomplete='off' aria-label='Type your signature' \/><style type='text\/css'>\n                #input_19_60_textinput::placeholder {\n                    font-size: 1.5rem;\n                    font-family: Arial;\n                    opacity: 0.8;\n                }\n            <\/style><\/div><div id='input_19_60_toolbar' class='gfield_signature_toolbar' dir='ltr' style='margin:5px 0;position:relative;height:35px;width:300px;max-width:100%;display:flex;align-items:center;'><div id='input_19_60_status' class='gfield_signature_status gform-visually-hidden' role='status' aria-live='polite' aria-atomic='true' style='position:absolute;width:1px;height:1px;padding:0;margin:-1px;overflow:hidden;clip:rect(0,0,0,0);white-space:nowrap;border:0;'><\/div><input type='hidden' id='input_19_60_font_select' class='gfield_signature_font_select' value='script' \/><div id='input_19_60_font_dropdown' class='gfield_signature_font_dropdown'><span class='gform-common-icon gform-common-icon--chevron-down gfield_signature_font_dropdown_icon'><\/span><button type='button' id='input_19_60_font_select_button' class='gfield_signature_font_select_button gform-theme__disable' tabindex='0' aria-haspopup='listbox' aria-expanded='false' aria-label='Font Options' style='width:100%;box-sizing:border-box;overflow:hidden;text-overflow:ellipsis;white-space:nowrap;font-family:\"Snell Roundhand\", \"Segoe Script\", cursive;color:#000000'>Your Name<\/button><ul id='input_19_60_font_select_list' class='gfield_signature_font_select_list' role='listbox' tabindex='-1' style='display:none;position:absolute;top:100%;left:0;right:0;margin:0;padding:0;list-style:none;background:#fff;border:1px solid #ccc;z-index:10;max-height:200px;overflow-y:auto;box-sizing:border-box;'><li class='gfield_signature_font_option' role='option' data-value='script' tabindex='0' style='font-family:&quot;Snell Roundhand&quot;, &quot;Segoe Script&quot;, cursive; color:#000000' aria-label='Your Name, Script style'>Your Name<\/li><li 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class='gform-common-icon gform-common-icon--pencil gfield_signature_draw_button gform-theme-no-framework' tabindex='0' style='display:none;background:none;border:0;padding:0;margin:0;appearance:none;-webkit-appearance:none;cursor:pointer;' alt='Draw Signature' aria-label='Draw Signature'><\/button><button type='button' id='input_19_60_resetbutton' class='gform-common-icon gform-common-icon--arrow-path gfield_signature_reset_button gform-theme-no-framework' tabindex='0' style='background:none;border:0;padding:0;margin:0;appearance:none;-webkit-appearance:none;cursor:pointer;' alt='Clear Signature' aria-label='Clear Signature'><\/button><\/div><\/div><\/div><\/div><\/li><li id=\"field_19_109\" class=\"gfield gfield--type-html gfield--input-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\"  ><\/li><\/ul><\/div>\n        <div class='gform-page-footer 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