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function FrameBuilder(formId,appendTo,initialHeight,iframeCode,title,embedStyleJSON){this.formId=formId;this.initialHeight=initialHeight;this.iframeCode=iframeCode;this.frame=null;this.timeInterval=200;this.appendTo=appendTo||false;this.formSubmitted=0;this.frameMinWidth='100%';this.defaultHeight='';this.init=function(){this.embedURLHash=this.getMD5(window.location.href);if(embedStyleJSON&&(embedStyleJSON[this.embedURLHash]&&embedStyleJSON[this.embedURLHash]['inlineStyle']['embedWidth'])){this.frameMinWidth=embedStyleJSON[this.embedURLHash]['inlineStyle']['embedWidth']+'px';}
if(embedStyleJSON&&(embedStyleJSON[this.embedURLHash])){if(embedStyleJSON[this.embedURLHash]['inlineStyle']&&embedStyleJSON[this.embedURLHash]['inlineStyle']['embedHeight']){this.defaultHeight='data-frameHeight="'+embedStyleJSON[this.embedURLHash]['inlineStyle']['embedHeight']+'"';}}
this.createFrame();this.addFrameContent(this.iframeCode);};this.createFrame=function(){var tmp_is_ie=!!window.ActiveXObject;this.iframeDomId=document.getElementById(this.formId)?this.formId+'_'+new Date().getTime():this.formId;var htmlCode="<"+"iframe title=\""+title.replace(/[\\"']/g,'\\$&').replace(/&amp;/g,'&')+"\" src=\"\" allowtransparency=\"true\" allow=\"geolocation; microphone; camera\" allowfullscreen=\"true\" name=\""+this.formId+"\" id=\""+this.iframeDomId+"\" style=\"width: 10px; min-width:"+this.frameMinWidth+"; display: block; overflow: hidden; height:"+this.initialHeight+"px; border: none;\" scrolling=\"no\""+this.defaultHeight+"></if"+"rame>";if(this.appendTo===false){document.write(htmlCode);}else{var tmp=document.createElement('div');tmp.innerHTML=htmlCode;var a=this.appendTo;document.getElementById(a).appendChild(tmp.firstChild);}
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this.addEvent(this.frame,'load',this.bindMethod(this.setTimer,this));var self=this;if(window.chrome!==undefined){this.frame.onload=function(){try{var doc=this.contentWindow.document;var _jotform=this.contentWindow.JotForm;if(doc!==undefined){var form=doc.getElementById(""+self.iframeDomId);self.addEvent(form,"submit",function(){if(_jotform.validateAll()){self.formSubmitted=1;}});}}catch(e){}}}};this.addEvent=function(obj,type,fn){if(obj.attachEvent){obj["e"+type+fn]=fn;obj[type+fn]=function(){obj["e"+type+fn](window.event);};obj.attachEvent("on"+type,obj[type+fn]);}
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this.changeHeight=function(){var actualHeight=this.getBodyHeight();var currentHeight=this.getViewPortHeight();var skipAutoHeight=(this.frame.contentWindow)?this.frame.contentWindow.document.querySelector('[data-welcome-view="true"]'):null;if(actualHeight===undefined){this.frame.style.height=this.frameHeight;if(!this.frame.style.minHeight){this.frame.style.minHeight="100vh";if(!('nojump'in this.frame.contentWindow.document.get)){window.parent.scrollTo(0,0);}}else if(!this.frame.dataset.parentScrolled){this.frame.dataset.parentScrolled=true;var container=window.parent.document&&window.parent.document.querySelector('.jt-content');if(container&&!('nojump'in window.parent.document.get)){container.scrollTo(0,0);}}}else if(Math.abs(actualHeight-currentHeight)>18&&!skipAutoHeight){this.frame.style.height=(actualHeight)+"px";}
this.setTimer();};this.bindMethod=function(method,scope){return function(){method.apply(scope,arguments);};};this.frameHeight=0;this.getBodyHeight=function(){if(this.formSubmitted===1){return;}
var height;var scrollHeight;var offsetHeight;try{if(this.frame.contentWindow.document.height){height=this.frame.contentWindow.document.height;if(this.frame.contentWindow.document.body.scrollHeight){height=scrollHeight=this.frame.contentWindow.document.body.scrollHeight;}
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return height;};this.getMD5=function(s){function L(k,d){return(k<<d)|(k>>>(32-d))}function K(G,k){var I,d,F,H,x;F=(G&2147483648);H=(k&2147483648);I=(G&1073741824);d=(k&1073741824);x=(G&1073741823)+(k&1073741823);if(I&d){return(x^2147483648^F^H)}if(I|d){if(x&1073741824){return(x^3221225472^F^H)}else{return(x^1073741824^F^H)}}else{return(x^F^H)}}function r(d,F,k){return(d&F)|((~d)&k)}function q(d,F,k){return(d&k)|(F&(~k))}function p(d,F,k){return(d^F^k)}function n(d,F,k){return(F^(d|(~k)))}function u(G,F,aa,Z,k,H,I){G=K(G,K(K(r(F,aa,Z),k),I));return K(L(G,H),F)}function f(G,F,aa,Z,k,H,I){G=K(G,K(K(q(F,aa,Z),k),I));return K(L(G,H),F)}function D(G,F,aa,Z,k,H,I){G=K(G,K(K(p(F,aa,Z),k),I));return K(L(G,H),F)}function t(G,F,aa,Z,k,H,I){G=K(G,K(K(n(F,aa,Z),k),I));return K(L(G,H),F)}function e(G){var Z;var F=G.length;var x=F+8;var k=(x-(x%64))/64;var I=(k+1)*16;var aa=Array(I-1);var d=0;var H=0;while(H<F){Z=(H-(H%4))/4;d=(H%4)*8;aa[Z]=(aa[Z]|(G.charCodeAt(H)<<d));H++}Z=(H-(H%4))/4;d=(H%4)*8;aa[Z]=aa[Z]|(128<<d);aa[I-2]=F<<3;aa[I-1]=F>>>29;return aa}function B(x){var k="",F="",G,d;for(d=0;d<=3;d++){G=(x>>>(d*8))&255;F="0"+G.toString(16);k=k+F.substr(F.length-2,2)}return k}function J(k){k=k.replace(/rn/g,"n");var d="";for(var F=0;F<k.length;F++){var x=k.charCodeAt(F);if(x<128){d+=String.fromCharCode(x)}else{if((x>127)&&(x<2048)){d+=String.fromCharCode((x>>6)|192);d+=String.fromCharCode((x&63)|128)}else{d+=String.fromCharCode((x>>12)|224);d+=String.fromCharCode(((x>>6)&63)|128);d+=String.fromCharCode((x&63)|128)}}}return d}var C=Array();var P,h,E,v,g,Y,X,W,V;var S=7,Q=12,N=17,M=22;var A=5,z=9,y=14,w=20;var o=4,m=11,l=16,j=23;var U=6,T=10,R=15,O=21;s=J(s);C=e(s);Y=1732584193;X=4023233417;W=2562383102;V=271733878;for(P=0;P<C.length;P+=16){h=Y;E=X;v=W;g=V;Y=u(Y,X,W,V,C[P+0],S,3614090360);V=u(V,Y,X,W,C[P+1],Q,3905402710);W=u(W,V,Y,X,C[P+2],N,606105819);X=u(X,W,V,Y,C[P+3],M,3250441966);Y=u(Y,X,W,V,C[P+4],S,4118548399);V=u(V,Y,X,W,C[P+5],Q,1200080426);W=u(W,V,Y,X,C[P+6],N,2821735955);X=u(X,W,V,Y,C[P+7],M,4249261313);Y=u(Y,X,W,V,C[P+8],S,1770035416);V=u(V,Y,X,W,C[P+9],Q,2336552879);W=u(W,V,Y,X,C[P+10],N,4294925233);X=u(X,W,V,Y,C[P+11],M,2304563134);Y=u(Y,X,W,V,C[P+12],S,1804603682);V=u(V,Y,X,W,C[P+13],Q,4254626195);W=u(W,V,Y,X,C[P+14],N,2792965006);X=u(X,W,V,Y,C[P+15],M,1236535329);Y=f(Y,X,W,V,C[P+1],A,4129170786);V=f(V,Y,X,W,C[P+6],z,3225465664);W=f(W,V,Y,X,C[P+11],y,643717713);X=f(X,W,V,Y,C[P+0],w,3921069994);Y=f(Y,X,W,V,C[P+5],A,3593408605);V=f(V,Y,X,W,C[P+10],z,38016083);W=f(W,V,Y,X,C[P+15],y,3634488961);X=f(X,W,V,Y,C[P+4],w,3889429448);Y=f(Y,X,W,V,C[P+9],A,568446438);V=f(V,Y,X,W,C[P+14],z,3275163606);W=f(W,V,Y,X,C[P+3],y,4107603335);X=f(X,W,V,Y,C[P+8],w,1163531501);Y=f(Y,X,W,V,C[P+13],A,2850285829);V=f(V,Y,X,W,C[P+2],z,4243563512);W=f(W,V,Y,X,C[P+7],y,1735328473);X=f(X,W,V,Y,C[P+12],w,2368359562);Y=D(Y,X,W,V,C[P+5],o,4294588738);V=D(V,Y,X,W,C[P+8],m,2272392833);W=D(W,V,Y,X,C[P+11],l,1839030562);X=D(X,W,V,Y,C[P+14],j,4259657740);Y=D(Y,X,W,V,C[P+1],o,2763975236);V=D(V,Y,X,W,C[P+4],m,1272893353);W=D(W,V,Y,X,C[P+7],l,4139469664);X=D(X,W,V,Y,C[P+10],j,3200236656);Y=D(Y,X,W,V,C[P+13],o,681279174);V=D(V,Y,X,W,C[P+0],m,3936430074);W=D(W,V,Y,X,C[P+3],l,3572445317);X=D(X,W,V,Y,C[P+6],j,76029189);Y=D(Y,X,W,V,C[P+9],o,3654602809);V=D(V,Y,X,W,C[P+12],m,3873151461);W=D(W,V,Y,X,C[P+15],l,530742520);X=D(X,W,V,Y,C[P+2],j,3299628645);Y=t(Y,X,W,V,C[P+0],U,4096336452);V=t(V,Y,X,W,C[P+7],T,1126891415);W=t(W,V,Y,X,C[P+14],R,2878612391);X=t(X,W,V,Y,C[P+5],O,4237533241);Y=t(Y,X,W,V,C[P+12],U,1700485571);V=t(V,Y,X,W,C[P+3],T,2399980690);W=t(W,V,Y,X,C[P+10],R,4293915773);X=t(X,W,V,Y,C[P+1],O,2240044497);Y=t(Y,X,W,V,C[P+8],U,1873313359);V=t(V,Y,X,W,C[P+15],T,4264355552);W=t(W,V,Y,X,C[P+6],R,2734768916);X=t(X,W,V,Y,C[P+13],O,1309151649);Y=t(Y,X,W,V,C[P+4],U,4149444226);V=t(V,Y,X,W,C[P+11],T,3174756917);W=t(W,V,Y,X,C[P+2],R,718787259);X=t(X,W,V,Y,C[P+9],O,3951481745);Y=K(Y,h);X=K(X,E);W=K(W,v);V=K(V,g)}var i=B(Y)+B(X)+B(W)+B(V);return i.toLowerCase()};this.init();}
FrameBuilder.get=qsProxy||[];var i213615407920148=new FrameBuilder("213615407920148",false,"","<!DOCTYPE HTML PUBLIC \"-\/\/W3C\/\/DTD HTML 4.01\/\/EN\" \"http:\/\/www.w3.org\/TR\/html4\/strict.dtd\">\n<html class=\"supernova\"><head>\n<meta http-equiv=\"Content-Type\" content=\"text\/html; charset=utf-8\" \/>\n<link rel=\"alternate\" type=\"application\/json+oembed\" href=\"https:\/\/www.jotform.com\/oembed\/?format=json&amp;url=https%3A%2F%2Fform.jotform.com%2F213615407920148\" title=\"oEmbed Form\">\n<link rel=\"alternate\" type=\"text\/xml+oembed\" href=\"https:\/\/www.jotform.com\/oembed\/?format=xml&amp;url=https%3A%2F%2Fform.jotform.com%2F213615407920148\" title=\"oEmbed Form\">\n<meta property=\"og:title\" content=\"\r\n            Login\r\n        \" >\n<meta property=\"og:url\" content=\"https:\/\/form.jotform.com\/213615407920148\" >\n<meta property=\"og:description\" content=\"Please click the link to complete this form.\" >\n<meta name=\"slack-app-id\" content=\"AHNMASS8M\">\n<link rel=\"shortcut icon\" href=\"https:\/\/cdn.jotfor.ms\/assets\/img\/favicons\/favicon-2021.svg\">\n<link rel=\"canonical\" href=\"https:\/\/form.jotform.com\/213615407920148\" \/>\n<meta name=\"viewport\" content=\"width=device-width, initial-scale=1.0, maximum-scale=2.0, user-scalable=1\" \/>\n<meta name=\"HandheldFriendly\" content=\"true\" \/>\n<title>\r\n            Login\r\n        <\/title>\n<style type=\"text\/css\">@media print{.form-section{display:inline!important}.form-pagebreak{display:none!important}.form-section-closed{height:auto!important}.page-section{position:initial!important}}<\/style>\n<link id=\"custom-font\" type=\"text\/css\" rel=\"stylesheet\" href=\"https:\/\/cdn.jotfor.ms\/opt\/google-fonts\/default\/fontface.css\" \/>\n<link type=\"text\/css\" rel=\"stylesheet\" href=\"https:\/\/cdn01.jotfor.ms\/themes\/CSS\/5e6b428acc8c4e222d1beb91.css?\"\/>\n<link type=\"text\/css\" rel=\"stylesheet\" href=\"https:\/\/cdn02.jotfor.ms\/css\/styles\/payment\/payment_styles.css?3.3.30862\" \/>\n<link type=\"text\/css\" rel=\"stylesheet\" href=\"https:\/\/cdn03.jotfor.ms\/css\/styles\/payment\/payment_feature.css?3.3.30862\" \/>\n<style type=\"text\/css\" id=\"form-designer-style\">\n    \/* Injected CSS Code *\/\n.form-all:after {\n  content: \"\";\n  display: table;\n  clear: both;\n}\n.form-all {\n  font-family: \"Open Sans\", sans-serif;\n}\n.form-all {\n  width: 415px;\n}\n.form-label-left,\n.form-label-right {\n  width: 0px;\n}\n.form-label {\n  white-space: normal;\n}\n.form-label.form-label-auto {\n  display: block;\n  float: none;\n  word-break: break-word;\n  text-align: left;\n}\n.form-label-left {\n  display: inline-block;\n  white-space: normal;\n  float: left;\n  text-align: left;\n}\n.form-label-right {\n  display: inline-block;\n  white-space: normal;\n  float: left;\n  text-align: right;\n}\n.form-label-top {\n  white-space: normal;\n  display: block;\n  float: none;\n  text-align: left;\n}\n.form-radio-item label:before {\n  top: 0;\n}\n.form-all {\n  font-size: 16px;\n}\n.form-label {\n  font-weight: bold;\n}\n.form-checkbox-item label,\n.form-radio-item label {\n  font-weight: normal;\n}\n.supernova {\n  background-color: #0e2433;\n  background-color: #ffffff;\n}\n.supernova body {\n  background-color: transparent;\n}\n\/*\n@width30: (unit(@formWidth, px) + 60px);\n@width60: (unit(@formWidth, px)+ 120px);\n@width90: (unit(@formWidth, px)+ 180px);\n*\/\n\/* | *\/\n@media screen and (min-width: 480px) {\n  .supernova .form-all {\n    border: 1px solid #e6e6e6;\n    box-shadow: 0 3px 9px rgba(0, 0, 0, 0.1);\n  }\n}\n\/* | *\/\n\/* | *\/\n@media screen and (max-width: 480px) {\n  .jotform-form .form-all {\n    margin: 0;\n    width: 100%;\n  }\n}\n\/* | *\/\n\/* | *\/\n@media screen and (min-width: 480px) and (max-width: 767px) {\n  .jotform-form .form-all {\n    margin: 0;\n    width: 100%;\n  }\n}\n\/* | *\/\n\/* | *\/\n@media screen and (min-width: 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#ffffff;\n}\n.form-line.form-line-active {\n  -webkit-transition-property: all;\n  -moz-transition-property: all;\n  -ms-transition-property: all;\n  -o-transition-property: all;\n  transition-property: all;\n  -webkit-transition-duration: 0.3s;\n  -moz-transition-duration: 0.3s;\n  -ms-transition-duration: 0.3s;\n  -o-transition-duration: 0.3s;\n  transition-duration: 0.3s;\n  -webkit-transition-timing-function: ease;\n  -moz-transition-timing-function: ease;\n  -ms-transition-timing-function: ease;\n  -o-transition-timing-function: ease;\n  transition-timing-function: ease;\n  background-color: rgba(255, 251, 234, 0);\n}\n\/* omer *\/\n.form-radio-item,\n.form-checkbox-item {\n  padding-bottom: 0px !important;\n}\n.form-radio-item:last-child,\n.form-checkbox-item:last-child {\n  padding-bottom: 0;\n}\n\/* omer *\/\n[data-type=\"control_radio\"] .form-input,\n[data-type=\"control_checkbox\"] .form-input,\n[data-type=\"control_radio\"] .form-input-wide,\n[data-type=\"control_checkbox\"] .form-input-wide {\n  width: 100%;\n  max-width: 300px;\n}\n.form-radio-item,\n.form-checkbox-item {\n  width: 100%;\n  max-width: 300px;\n  box-sizing: border-box;\n}\n.form-textbox.form-radio-other-input,\n.form-textbox.form-checkbox-other-input {\n  width: 80%;\n  margin-left: 3%;\n  box-sizing: border-box;\n}\n.form-multiple-column {\n  width: 100%;\n}\n.form-multiple-column .form-radio-item,\n.form-multiple-column .form-checkbox-item {\n  width: 10%;\n}\n.form-multiple-column[data-columncount=\"1\"] .form-radio-item,\n.form-multiple-column[data-columncount=\"1\"] .form-checkbox-item {\n  width: 100%;\n}\n.form-multiple-column[data-columncount=\"2\"] .form-radio-item,\n.form-multiple-column[data-columncount=\"2\"] .form-checkbox-item {\n  width: 50%;\n}\n.form-multiple-column[data-columncount=\"3\"] .form-radio-item,\n.form-multiple-column[data-columncount=\"3\"] .form-checkbox-item {\n  width: 33.33333333%;\n}\n.form-multiple-column[data-columncount=\"4\"] .form-radio-item,\n.form-multiple-column[data-columncount=\"4\"] .form-checkbox-item {\n  width: 25%;\n}\n.form-multiple-column[data-columncount=\"5\"] .form-radio-item,\n.form-multiple-column[data-columncount=\"5\"] .form-checkbox-item {\n  width: 20%;\n}\n.form-multiple-column[data-columncount=\"6\"] .form-radio-item,\n.form-multiple-column[data-columncount=\"6\"] .form-checkbox-item {\n  width: 16.66666667%;\n}\n.form-multiple-column[data-columncount=\"7\"] .form-radio-item,\n.form-multiple-column[data-columncount=\"7\"] .form-checkbox-item {\n  width: 14.28571429%;\n}\n.form-multiple-column[data-columncount=\"8\"] .form-radio-item,\n.form-multiple-column[data-columncount=\"8\"] .form-checkbox-item {\n  width: 12.5%;\n}\n.form-multiple-column[data-columncount=\"9\"] .form-radio-item,\n.form-multiple-column[data-columncount=\"9\"] .form-checkbox-item {\n  width: 11.11111111%;\n}\n.form-single-column .form-checkbox-item,\n.form-single-column .form-radio-item {\n  width: 100%;\n}\n.form-checkbox-item .editor-container div,\n.form-radio-item .editor-container div {\n  position: relative;\n}\n.form-checkbox-item .editor-container div:before,\n.form-radio-item .editor-container div:before {\n  display: inline-block;\n  vertical-align: middle;\n  box-sizing: border-box;\n  left: 0;\n  width: 18px;\n  height: 18px;\n}\n.form-checkbox-item,\n.form-radio-item {\n  padding-left: 2px;\n}\n.form-checkbox-item input,\n.form-radio-item input {\n  margin-top: 2px;\n}\n.supernova {\n  height: 100%;\n  background-repeat: no-repeat;\n  background-attachment: scroll;\n  background-position: center top;\n  background-repeat: repeat;\n}\n.supernova {\n  background-image: none;\n}\n#stage {\n  background-image: none;\n}\n\/* | *\/\n.form-all {\n  background-repeat: no-repeat;\n  background-attachment: scroll;\n  background-position: center top;\n  background-repeat: repeat;\n}\n.form-header-group {\n  background-repeat: no-repeat;\n  background-attachment: scroll;\n  background-position: center top;\n}\n.form-line {\n  margin-top: 0px;\n  margin-bottom: 0px;\n}\n.form-line {\n  padding: 12px 36px;\n}\n.form-all .qq-upload-button,\n.form-all .form-submit-button,\n.form-all .form-submit-reset,\n.form-all .form-submit-print {\n  font-size: 1em;\n  padding: 9px 15px;\n  font-family: \"Open Sans\", sans-serif;\n  font-size: 16px;\n  font-weight: bold;\n}\n.form-all .qq-upload-button,\n.form-all .form-submit-button,\n.form-all .form-submit-reset,\n.form-all .form-submit-print {\n  color: #ffffff !important;\n  background: #65bb11;\n  box-shadow: none;\n  text-shadow: none;\n}\n.form-all .form-pagebreak-back,\n.form-all .form-pagebreak-next {\n  font-size: 1em;\n  padding: 9px 15px;\n  font-family: \"Open Sans\", sans-serif;\n  font-size: 16px;\n  font-weight: normal;\n}\n\/*\n& when ( @buttonFontType = google ) {\n\t@import (css) \"@{buttonFontLink}\";\n}\n*\/\nh2.form-header {\n  line-height: 1.618em;\n  font-size: 1.714em;\n}\nh2 ~ .form-subHeader {\n  line-height: 1.5em;\n  font-size: 1.071em;\n}\n.form-header-group {\n  text-align: left;\n}\n.form-line {\n  zoom: 1;\n}\n.form-line:before,\n.form-line:after {\n  display: table;\n  content: '';\n  line-height: 0;\n}\n.form-line:after {\n  clear: both;\n}\n.form-captcha input,\n.form-spinner input {\n  width: 300px;\n}\n.form-textbox,\n.form-textarea {\n  width: 100%;\n  max-width: 300px;\n  box-sizing: border-box;\n}\n.form-input,\n.form-address-table,\n.form-matrix-table {\n  width: 100%;\n  max-width: 300px;\n}\n.form-radio-item,\n.form-checkbox-item {\n  width: 100%;\n  max-width: 300px;\n  box-sizing: border-box;\n}\n.form-textbox.form-radio-other-input,\n.form-textbox.form-checkbox-other-input {\n  width: 80%;\n  margin-left: 3%;\n  box-sizing: border-box;\n}\n.form-multiple-column {\n  width: 100%;\n}\n.form-multiple-column .form-radio-item,\n.form-multiple-column .form-checkbox-item {\n  width: 10%;\n}\n.form-multiple-column[data-columncount=\"1\"] .form-radio-item,\n.form-multiple-column[data-columncount=\"1\"] .form-checkbox-item {\n  width: 100%;\n}\n.form-multiple-column[data-columncount=\"2\"] .form-radio-item,\n.form-multiple-column[data-columncount=\"2\"] .form-checkbox-item {\n  width: 50%;\n}\n.form-multiple-column[data-columncount=\"3\"] .form-radio-item,\n.form-multiple-column[data-columncount=\"3\"] .form-checkbox-item {\n  width: 33.33333333%;\n}\n.form-multiple-column[data-columncount=\"4\"] .form-radio-item,\n.form-multiple-column[data-columncount=\"4\"] .form-checkbox-item {\n  width: 25%;\n}\n.form-multiple-column[data-columncount=\"5\"] .form-radio-item,\n.form-multiple-column[data-columncount=\"5\"] .form-checkbox-item {\n  width: 20%;\n}\n.form-multiple-column[data-columncount=\"6\"] .form-radio-item,\n.form-multiple-column[data-columncount=\"6\"] .form-checkbox-item {\n  width: 16.66666667%;\n}\n.form-multiple-column[data-columncount=\"7\"] .form-radio-item,\n.form-multiple-column[data-columncount=\"7\"] .form-checkbox-item {\n  width: 14.28571429%;\n}\n.form-multiple-column[data-columncount=\"8\"] .form-radio-item,\n.form-multiple-column[data-columncount=\"8\"] .form-checkbox-item {\n  width: 12.5%;\n}\n.form-multiple-column[data-columncount=\"9\"] .form-radio-item,\n.form-multiple-column[data-columncount=\"9\"] .form-checkbox-item {\n  width: 11.11111111%;\n}\n[data-type=\"control_dropdown\"] .form-dropdown {\n  width: 100% !important;\n  max-width: 300px;\n}\n[data-type=\"control_fullname\"] .form-sub-label-container {\n  box-sizing: border-box;\n  width: 48%;\n}\n[data-type=\"control_fullname\"] .form-sub-label-container:first-child {\n  margin-right: 4%;\n}\n[data-type=\"control_phone\"] .form-sub-label-container {\n  width: 62.5%;\n  margin-left: 2.5%;\n  margin-right: 0;\n  float: left;\n  position: relative;\n}\n[data-type=\"control_phone\"] .form-sub-label-container:first-child {\n  width: 32.5%;\n  margin-right: 2.5%;\n  margin-left: 0;\n}\n[data-type=\"control_phone\"] .form-sub-label-container:first-child [data-component=areaCode] {\n  width: 93%;\n  float: left;\n}\n[data-type=\"control_phone\"] .form-sub-label-container:first-child [data-component=areaCode] ~ .form-sub-label {\n  display: inline-block;\n}\n[data-type=\"control_phone\"] .form-sub-label-container:first-child .phone-separate {\n  position: absolute;\n  top: 0;\n  right: -16%;\n  width: 24%;\n  text-align: center;\n  text-indent: -4px;\n}\n[data-type=\"control_birthdate\"] .form-sub-label-container {\n  width: 22%;\n  margin-right: 3%;\n}\n[data-type=\"control_birthdate\"] .form-sub-label-container:first-child {\n  width: 50%;\n}\n[data-type=\"control_birthdate\"] .form-sub-label-container:last-child {\n  margin-right: 0;\n}\n[data-type=\"control_birthdate\"] .form-sub-label-container .form-dropdown {\n  width: 100%;\n}\n[data-type=\"control_payment\"] .form-sub-label-container {\n  width: auto;\n}\n[data-type=\"control_payment\"] .form-sub-label-container .form-dropdown {\n  width: 100%;\n}\n.form-address-table td .form-dropdown {\n  width: 100%;\n}\n.form-address-table td .form-sub-label-container {\n  width: 96%;\n}\n.form-address-table td:last-child .form-sub-label-container {\n  margin-left: 4%;\n}\n.form-address-table td[colspan=\"2\"] .form-sub-label-container {\n  width: 100%;\n  margin: 0;\n}\n\/*.form-dropdown,\n.form-radio-item,\n.form-checkbox-item,\n.form-radio-other-input,\n.form-checkbox-other-input,*\/\n.form-captcha input,\n.form-spinner input,\n.form-error-message {\n  padding: 4px 3px 2px 3px;\n}\n.form-header-group {\n  font-family: \"Open Sans\", sans-serif;\n}\n.form-section {\n  padding: 0px 0px 0px 0px;\n}\n.form-header-group {\n  margin: 12px 36px 12px 36px;\n}\n.form-header-group {\n  padding: 24px 0px 24px 0px;\n}\n.form-textbox,\n.form-textarea {\n  padding: 1px 0px -1px 0px;\n}\n.form-textbox,\n.form-textarea {\n  width: 100%;\n  max-width: 300px;\n  box-sizing: border-box;\n}\n[data-type=\"control_textbox\"] .form-input,\n[data-type=\"control_textarea\"] .form-input,\n[data-type=\"control_fullname\"] .form-input,\n[data-type=\"control_phone\"] .form-input,\n[data-type=\"control_datetime\"] .form-input,\n[data-type=\"control_address\"] .form-input,\n[data-type=\"control_email\"] .form-input,\n[data-type=\"control_passwordbox\"] .form-input,\n[data-type=\"control_autocomp\"] .form-input,\n[data-type=\"control_textbox\"] .form-input-wide,\n[data-type=\"control_textarea\"] .form-input-wide,\n[data-type=\"control_fullname\"] .form-input-wide,\n[data-type=\"control_phone\"] .form-input-wide,\n[data-type=\"control_datetime\"] .form-input-wide,\n[data-type=\"control_address\"] .form-input-wide,\n[data-type=\"control_email\"] .form-input-wide,\n[data-type=\"control_passwordbox\"] .form-input-wide,\n[data-type=\"control_autocomp\"] .form-input-wide {\n  width: 100%;\n  max-width: 300px;\n}\n[data-type=\"control_fullname\"] .form-sub-label-container {\n  box-sizing: border-box;\n  width: 48%;\n  margin-right: 0;\n  float: left;\n}\n[data-type=\"control_fullname\"] .form-sub-label-container:first-child {\n  margin-right: 4%;\n}\n[data-type=\"control_phone\"] .form-sub-label-container {\n  width: 62.5%;\n  margin-left: 2.5%;\n  margin-right: 0;\n  float: left;\n  position: relative;\n}\n[data-type=\"control_phone\"] .form-sub-label-container:first-child {\n  width: 32.5%;\n  margin-right: 2.5%;\n  margin-left: 0;\n}\n[data-type=\"control_phone\"] .form-sub-label-container:first-child [data-component=areaCode] {\n  width: 93%;\n  float: left;\n}\n[data-type=\"control_phone\"] .form-sub-label-container:first-child [data-component=areaCode] ~ .form-sub-label {\n  display: inline-block;\n}\n[data-type=\"control_phone\"] .form-sub-label-container:first-child .phone-separate {\n  position: absolute;\n  top: 0;\n  right: -16%;\n  width: 24%;\n  text-align: center;\n  text-indent: -4px;\n}\n[data-type=\"control_phone\"] .form-sub-label-container .date-separate {\n  visibility: hidden;\n}\n.form-matrix-table {\n  width: 100%;\n  max-width: 300px;\n}\n.form-address-table {\n  width: 100%;\n  max-width: 300px;\n}\n.form-address-table td .form-dropdown {\n  width: 100%;\n}\n.form-address-table td .form-sub-label-container {\n  width: 96%;\n}\n.form-address-table td:last-child .form-sub-label-container {\n  margin-left: 4%;\n}\n.form-address-table td[colspan=\"2\"] .form-sub-label-container {\n  width: 100%;\n  margin: 0;\n}\n.form-matrix-row-headers,\n.form-matrix-column-headers,\n.form-matrix-values {\n  padding: 4px;\n}\n[data-type=\"control_dropdown\"] .form-input,\n[data-type=\"control_birthdate\"] .form-input,\n[data-type=\"control_time\"] .form-input,\n[data-type=\"control_dropdown\"] .form-input-wide,\n[data-type=\"control_birthdate\"] .form-input-wide,\n[data-type=\"control_time\"] .form-input-wide {\n  width: 100%;\n  max-width: 300px;\n}\n[data-type=\"control_dropdown\"] .form-dropdown {\n  width: 100% !important;\n  max-width: 300px;\n}\n[data-type=\"control_birthdate\"] .form-sub-label-container {\n  width: 22%;\n  margin-right: 3%;\n}\n[data-type=\"control_birthdate\"] .form-sub-label-container:first-child {\n  width: 50%;\n}\n[data-type=\"control_birthdate\"] .form-sub-label-container:last-child {\n  margin-right: 0;\n}\n[data-type=\"control_birthdate\"] .form-sub-label-container .form-dropdown {\n  width: 100%;\n}\n.form-label {\n  font-family: \"Open Sans\", sans-serif;\n}\nli[data-type=\"control_image\"] div {\n  text-align: Left;\n}\nli[data-type=\"control_image\"] img {\n  border: none;\n  border-width: 0px !important;\n  border-style: solid !important;\n  border-color: false !important;\n}\n.form-line-column {\n  width: auto;\n}\n.form-line-error {\n  overflow: hidden;\n  -webkit-transition-property: none;\n  -moz-transition-property: none;\n  -ms-transition-property: none;\n  -o-transition-property: none;\n  transition-property: none;\n  -webkit-transition-duration: 0.3s;\n  -moz-transition-duration: 0.3s;\n  -ms-transition-duration: 0.3s;\n  -o-transition-duration: 0.3s;\n  transition-duration: 0.3s;\n  -webkit-transition-timing-function: ease;\n  -moz-transition-timing-function: ease;\n  -ms-transition-timing-function: ease;\n  -o-transition-timing-function: ease;\n  transition-timing-function: ease;\n  background-color: #fff4f4;\n}\n.form-line-error .form-error-message {\n  background-color: #ff3200;\n  clear: both;\n  float: none;\n}\n.form-line-error .form-error-message .form-error-arrow {\n  border-bottom-color: #ff3200;\n}\n.form-line-error input:not(#coupon-input),\n.form-line-error textarea,\n.form-line-error .form-validation-error {\n  border: 1px solid #ff3200;\n  box-shadow: 0 0 3px #ff3200;\n}\n.ie-8 .form-all {\n  margin-top: auto;\n  margin-top: initial;\n}\n.ie-8 .form-all:before {\n  display: none;\n}\n[data-type=\"control_clear\"] {\n  display: none;\n}\n\/* | *\/\n@media screen and (max-width: 480px), screen and (max-device-width: 767px) and (orientation: portrait), screen and (max-device-width: 415px) and (orientation: landscape) {\n  .testOne {\n    letter-spacing: 0;\n  }\n  .form-all {\n    border: 0;\n    max-width: initial;\n  }\n  .form-sub-label-container {\n    width: 100%;\n    margin: 0;\n    margin-right: 0;\n    float: left;\n    box-sizing: border-box;\n  }\n  span.form-sub-label-container + span.form-sub-label-container {\n    margin-right: 0;\n  }\n  .form-sub-label {\n    white-space: normal;\n  }\n  .form-address-table td,\n  .form-address-table th {\n    padding: 0 1px 10px;\n  }\n  .form-submit-button,\n  .form-submit-print,\n  .form-submit-reset {\n    width: 100%;\n    margin-left: 0!important;\n  }\n  div[id*=at_] {\n    font-size: 14px;\n    font-weight: 700;\n    height: 8px;\n    margin-top: 6px;\n  }\n  .showAutoCalendar {\n    width: 20px;\n  }\n  img.form-image {\n    max-width: 100%;\n    height: auto;\n  }\n  .form-matrix-row-headers {\n    width: 100%;\n    word-break: break-all;\n    min-width: 80px;\n  }\n  .form-collapse-table,\n  .form-header-group {\n    margin: 0;\n  }\n  .form-collapse-table {\n    height: 100%;\n    display: inline-block;\n    width: 100%;\n  }\n  .form-collapse-hidden {\n    display: none !important;\n  }\n  .form-input {\n    width: 100%;\n  }\n  .form-label {\n    width: 100% !important;\n  }\n  .form-label-left,\n  .form-label-right {\n    display: block;\n    float: none;\n    text-align: left;\n    width: auto!important;\n  }\n  .form-line,\n  .form-line.form-line-column {\n    padding: 2% 5%;\n    box-sizing: border-box;\n  }\n  input[type=text],\n  input[type=email],\n  input[type=tel],\n  textarea {\n    width: 100%;\n    box-sizing: border-box;\n    max-width: initial !important;\n  }\n  .form-radio-other-input,\n  .form-checkbox-other-input {\n    max-width: 55% !important;\n  }\n  .form-dropdown,\n  .form-textarea,\n  .form-textbox {\n    width: 100%!important;\n    box-sizing: border-box;\n  }\n  .form-input,\n  .form-input-wide,\n  .form-textarea,\n  .form-textbox,\n  .form-dropdown {\n    max-width: initial!important;\n  }\n  .form-checkbox-item:not(#foo),\n  .form-radio-item:not(#foo) {\n    width: 100%;\n  }\n  .form-address-city,\n  .form-address-line,\n  .form-address-postal,\n  .form-address-state,\n  .form-address-table,\n  .form-address-table .form-sub-label-container,\n  .form-address-table select,\n  .form-input {\n    width: 100%;\n  }\n  div.form-header-group {\n    padding: 24px 0px !important;\n    margin: 0 12px 2% !important;\n    margin-left: 5%!important;\n    margin-right: 5%!important;\n    box-sizing: border-box;\n  }\n  div.form-header-group.hasImage img {\n    max-width: 100%;\n  }\n  [data-type=\"control_button\"] {\n    margin-bottom: 0 !important;\n  }\n  [data-type=control_fullname] .form-sub-label-container {\n    width: 48%;\n  }\n  [data-type=control_fullname] .form-sub-label-container:first-child {\n    margin-right: 4%;\n  }\n  [data-type=control_phone] .form-sub-label-container {\n    width: 65%;\n    margin-right: 0;\n    margin-left: 0;\n    float: left;\n  }\n  [data-type=control_phone] .form-sub-label-container:first-child {\n    width: 31%;\n    margin-right: 4%;\n  }\n  [data-type=control_datetime] .allowTime-container {\n    width: 100%;\n  }\n  [data-type=control_datetime] .allowTime-container .form-sub-label-container {\n    width: 24%!important;\n    margin-left: 6%;\n    margin-right: 0;\n  }\n  [data-type=control_datetime] .allowTime-container .form-sub-label-container:first-child {\n    margin-left: 0;\n  }\n  [data-type=control_datetime] span + span + span > span:first-child {\n    display: block;\n    width: 100% !important;\n  }\n  [data-type=control_birthdate] .form-sub-label-container,\n  [data-type=control_time] .form-sub-label-container {\n    width: 27.3%!important;\n    margin-right: 6% !important;\n  }\n  [data-type=control_time] .form-sub-label-container:last-child {\n    width: 33.3%!important;\n    margin-right: 0 !important;\n  }\n  .form-pagebreak-back-container,\n  .form-pagebreak-next-container {\n    min-height: 1px;\n    width: 50% !important;\n  }\n  .form-pagebreak-back,\n  .form-pagebreak-next,\n  .form-product-item.hover-product-item {\n    width: 100%;\n  }\n  .form-pagebreak-back-container {\n    padding: 0;\n    text-align: right;\n  }\n  .form-pagebreak-next-container {\n    padding: 0;\n    text-align: left;\n  }\n  .form-pagebreak {\n    margin: 0 auto;\n  }\n  .form-buttons-wrapper {\n    margin: 0!important;\n    margin-left: 0!important;\n  }\n  .form-buttons-wrapper button {\n    width: 100%;\n  }\n  .form-buttons-wrapper .form-submit-print {\n    margin: 0 !important;\n  }\n  table {\n    width: 100%!important;\n    max-width: initial!important;\n  }\n  table td + td {\n    padding-left: 3%;\n  }\n  .form-checkbox-item,\n  .form-radio-item {\n    white-space: normal!important;\n  }\n  .form-checkbox-item input,\n  .form-radio-item input {\n    width: auto;\n  }\n  .form-collapse-table {\n    margin: 0 5%;\n    display: block;\n    zoom: 1;\n    width: auto;\n  }\n  .form-collapse-table:before,\n  .form-collapse-table:after {\n    display: table;\n    content: '';\n    line-height: 0;\n  }\n  .form-collapse-table:after {\n    clear: both;\n  }\n  .fb-like-box {\n    width: 98% !important;\n  }\n  .form-error-message {\n    clear: both;\n    bottom: -10px;\n  }\n  .date-separate,\n  .phone-separate {\n    display: none;\n  }\n  .custom-field-frame,\n  .direct-embed-widgets,\n  .signature-pad-wrapper {\n    width: 100% !important;\n  }\n}\n\/* | *\/\n\n\/*__INSPECT_SEPERATOR__*\/\n.form-label.form-label-auto {\n    display : none;\n    float : none;\n    text-align : center;\n    width : 0px;\n}\n\n.form-textbox {\n    width : 100% !important;\n}\n\n.form-header-group {\n    border : none;\n    padding : 0px;\n    margin : 10px 5px 0px 5px;\n}\n\n.form-section.page-section {\n    padding-left : 5px !important;\n    padding-right : 5px !important;\n    height : 500px;\n}\n\n.form-required {\n    display : none !important;\n}\n\n.form-buttons-wrapper.form-buttons-center.jsTest-button-wrapperField {\n    border : none;\n    padding : 20px 17px 20px 10px;\n}\n\n.form-line {\n    padding : 0px 0px 0px 0px;\n    margin : 2px 20px 2px 20px;\n}\n\n.form-all .form-submit-button:hover {\n    color : #FFFFFF !important;\n    background : #4D92C7 !important;\n}\n\n.form-html {\n    padding : 0px;\n    margin : 0px;\n}\n\n#input_3 {\n    width : 300px;\n    height : 50px;\n    font-size : 22px;\n}\n\n.form-header {\n    font-size : 22px;\n}\n\n.form-html p {\n    font-size : 18px;\n}\n\n\n    \/* Injected CSS Code *\/\n<\/style>\n\n<script src=\"https:\/\/cdn01.jotfor.ms\/static\/prototype.forms.js\" type=\"text\/javascript\"><\/script>\n<script src=\"https:\/\/cdn02.jotfor.ms\/static\/jotform.forms.js?3.3.30862\" 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