{"id":1906,"date":"2018-06-13T22:21:18","date_gmt":"2018-06-13T22:21:18","guid":{"rendered":"https:\/\/nau.edu\/sherc\/?page_id=1906"},"modified":"2025-08-19T16:53:15","modified_gmt":"2025-08-19T16:53:15","slug":"contact-form","status":"publish","type":"page","link":"https:\/\/in.nau.edu\/sherc\/contact-form\/","title":{"rendered":"Contact Form"},"content":{"rendered":"<h1>SHERC contact form<\/h1>\n<p>For further information or to answer your questions, please complete our contact form.<\/p>\n<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_1' style='display:none'><form method='post' enctype='multipart\/form-data'  id='gform_1'  action='\/sherc\/wp-json\/wp\/v2\/pages\/1906' data-formid='1' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_1' class='gform_fields top_label form_sublabel_below description_above validation_below'><li id=\"field_1_13\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_13'><span class='gform-field-label__text'>Facebook<\/span><\/label><div class='gfield_description' id='gfield_description_1_13'>This field is for validation purposes and should be left unchanged.<\/div><div class='ginput_container'><input name='input_13' id='input_1_13' type='text' value='' autocomplete='new-password'\/><\/div><\/li><li id=\"field_1_1\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_1'><span class='gform-field-label__text'>First name<\/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_1' id='input_1_1' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_1_2\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_2'><span class='gform-field-label__text'>Last name<\/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_2' id='input_1_2' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_1_5\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_5'><span class='gform-field-label__text'>How can we help you?<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_5' id='input_1_5' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_1_4\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--has-description field_description_above 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'>Role<\/span><\/label><div class='gfield_description' id='gfield_description_1_4'>Select all that apply<\/div><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_1_4'><li class='gchoice gchoice_1_4_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_4.1' type='checkbox'  value='Community Member'  id='choice_1_4_1'   aria-describedby=\"gfield_description_1_4\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_1_4_1' id='label_1_4_1' class='gform-field-label gform-field-label--type-inline'>Community Member<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_4_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_4.2' type='checkbox'  value='Faculty'  id='choice_1_4_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_4_2' id='label_1_4_2' class='gform-field-label gform-field-label--type-inline'>Faculty<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_4_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_4.3' type='checkbox'  value='Healthcare Professional'  id='choice_1_4_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_4_3' id='label_1_4_3' class='gform-field-label gform-field-label--type-inline'>Healthcare Professional<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_4_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_4.4' type='checkbox'  value='Health Educator'  id='choice_1_4_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_4_4' id='label_1_4_4' class='gform-field-label gform-field-label--type-inline'>Health Educator<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_4_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_4.5' type='checkbox'  value='NAU-Affiliated'  id='choice_1_4_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_4_5' id='label_1_4_5' class='gform-field-label gform-field-label--type-inline'>NAU-Affiliated<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_4_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_4.6' type='checkbox'  value='Staff'  id='choice_1_4_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_4_6' id='label_1_4_6' class='gform-field-label gform-field-label--type-inline'>Staff<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_4_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_4.7' type='checkbox'  value='Student'  id='choice_1_4_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_4_7' id='label_1_4_7' class='gform-field-label gform-field-label--type-inline'>Student<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_4_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_4.8' type='checkbox'  value='Other'  id='choice_1_4_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_4_8' id='label_1_4_8' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_1_10\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_10'><span class='gform-field-label__text'>If other, please specify<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_1_10' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_1_11\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--has-description field_description_above 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'>Sector<\/span><\/label><div class='gfield_description' id='gfield_description_1_11'>Select a sector that best describes your area of work \u2013 select all that apply<\/div><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_1_11'><li class='gchoice gchoice_1_11_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.1' type='checkbox'  value='Education'  id='choice_1_11_1'   aria-describedby=\"gfield_description_1_11\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_1_11_1' id='label_1_11_1' class='gform-field-label gform-field-label--type-inline'>Education<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_11_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.2' type='checkbox'  value='Government'  id='choice_1_11_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_11_2' id='label_1_11_2' class='gform-field-label gform-field-label--type-inline'>Government<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_11_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.3' type='checkbox'  value='Healthcare'  id='choice_1_11_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_11_3' id='label_1_11_3' class='gform-field-label gform-field-label--type-inline'>Healthcare<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_11_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.4' type='checkbox'  value='Non-profit'  id='choice_1_11_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_11_4' id='label_1_11_4' class='gform-field-label gform-field-label--type-inline'>Non-profit<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_11_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.5' type='checkbox'  value='Private'  id='choice_1_11_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_11_5' id='label_1_11_5' class='gform-field-label gform-field-label--type-inline'>Private<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_11_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.6' type='checkbox'  value='Public health'  id='choice_1_11_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_11_6' id='label_1_11_6' class='gform-field-label gform-field-label--type-inline'>Public health<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_11_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.7' type='checkbox'  value='Tribal'  id='choice_1_11_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_11_7' id='label_1_11_7' class='gform-field-label gform-field-label--type-inline'>Tribal<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_11_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.8' type='checkbox'  value='Other'  id='choice_1_11_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_11_8' id='label_1_11_8' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_1_12\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_12'><span class='gform-field-label__text'>If other, please specify<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_1_12' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_1_6\" class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_6'><span class='gform-field-label__text'>Email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_6' id='input_1_6' type='email' value='' class='medium'   placeholder='e.g. abc132@nau.edu' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_1_7\" class=\"gfield gfield--type-phone gfield--phone-format-standard field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_7'><span class='gform-field-label__text'>Phone<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_7' id='input_1_7' type='tel' value='' class='medium'  placeholder='e.g. (520) 478-4353'  aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/li><li id=\"field_1_8\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Would you like to be added to our e-mail list to learn more about events and updates from SHERC and CHER?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_1_8'>\n\t\t\t<li class='gchoice gchoice_1_8_0'>\n\t\t\t\t<input name='input_8' type='radio' value='Yes'  id='choice_1_8_0'    \/>\n\t\t\t\t<label for='choice_1_8_0' id='label_1_8_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_8_1'>\n\t\t\t\t<input name='input_8' type='radio' value='No'  id='choice_1_8_1'    \/>\n\t\t\t\t<label for='choice_1_8_1' id='label_1_8_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><\/ul><\/div>\n        <div class='gform-footer gform_footer top_label'> <button type='submit' id='gform_submit_button_1' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Submit<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_1' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_1' id='gform_theme_1' value='legacy' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_1' id='gform_style_settings_1' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_1' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='1' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='aAn5OM1aUbUXWv9WKij1SvQJWm5+OmiAG2JNildrXDpH0uXUHxC5YEkIyZX341xOZH47Ha5SlaWlTl8cnzZVookPOyNT11fDyoHrYBaz0BCm0tI=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_1' value='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' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_1' id='gform_target_page_number_1' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_1' id='gform_source_page_number_1' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div>\n","protected":false},"excerpt":{"rendered":"<p>SHERC contact form For further information or to answer your questions, please complete our contact form.<\/p>\n","protected":false},"author":259,"featured_media":2704,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"ring_central_script_selection":"","footnotes":""},"class_list":["post-1906","page","type-page","status-publish","has-post-thumbnail","hentry"],"_links":{"self":[{"href":"https:\/\/in.nau.edu\/sherc\/wp-json\/wp\/v2\/pages\/1906","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/in.nau.edu\/sherc\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/in.nau.edu\/sherc\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/in.nau.edu\/sherc\/wp-json\/wp\/v2\/users\/259"}],"replies":[{"embeddable":true,"href":"https:\/\/in.nau.edu\/sherc\/wp-json\/wp\/v2\/comments?post=1906"}],"version-history":[{"count":14,"href":"https:\/\/in.nau.edu\/sherc\/wp-json\/wp\/v2\/pages\/1906\/revisions"}],"predecessor-version":[{"id":2972,"href":"https:\/\/in.nau.edu\/sherc\/wp-json\/wp\/v2\/pages\/1906\/revisions\/2972"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/in.nau.edu\/sherc\/wp-json\/wp\/v2\/media\/2704"}],"wp:attachment":[{"href":"https:\/\/in.nau.edu\/sherc\/wp-json\/wp\/v2\/media?parent=1906"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}