{"id":7765,"date":"2024-02-14T20:37:28","date_gmt":"2024-02-14T20:37:28","guid":{"rendered":"https:\/\/scautism.org\/?page_id=7765"},"modified":"2024-02-14T21:51:53","modified_gmt":"2024-02-14T21:51:53","slug":"contact-us-2","status":"publish","type":"page","link":"https:\/\/scautism.org\/contact-us-2\/","title":{"rendered":"Contact Us"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; admin_label=&#8221;section&#8221; _builder_version=&#8221;4.16&#8243; global_colors_info=&#8221;{}&#8221;][et_pb_row admin_label=&#8221;row&#8221; _builder_version=&#8221;4.16&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;|||&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_text admin_label=&#8221;Text&#8221; _builder_version=&#8221;4.24.0&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h1>Contact Us<\/h1>\n<p>[\/et_pb_text][wpforms_selector form_id=&#8221;4832&#8243; _builder_version=&#8221;4.24.0&#8243; _module_preset=&#8221;default&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;][\/wpforms_selector][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Contact Us<div class=\"et_pb_module wpforms_selector wpforms_selector_0\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<div class=\"et_pb_module_inner\">\n\t\t\t\t\t<div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-4832\"><form id=\"wpforms-form-4832\" class=\"wpforms-validate wpforms-form\" data-formid=\"4832\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/wp-json\/wp\/v2\/pages\/7765\" data-token=\"813c0722b05bc77e5e2d2fab7ffca79d\" data-token-time=\"1715144625\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-4832-field_1-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-4832-field_1\">Name <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-4832-field_1\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][1][first]\" required><label for=\"wpforms-4832-field_1\" class=\"wpforms-field-sublabel after \">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-4832-field_1-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][1][last]\" required><label for=\"wpforms-4832-field_1-last\" class=\"wpforms-field-sublabel after \">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-4832-field_2-container\" class=\"wpforms-field wpforms-field-phone wpforms-one-half wpforms-first\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-4832-field_2\">Phone <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"tel\" id=\"wpforms-4832-field_2\" class=\"wpforms-field-medium wpforms-field-required wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][2]\" required><\/div><div id=\"wpforms-4832-field_3-container\" class=\"wpforms-field wpforms-field-email wpforms-one-half\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-4832-field_3\">Email <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-4832-field_3\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][3]\" spellcheck=\"false\" required><\/div><div id=\"wpforms-4832-field_4-container\" class=\"wpforms-field wpforms-field-address\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-4832-field_4\">Address <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div ><input type=\"text\" id=\"wpforms-4832-field_4\" class=\"wpforms-field-address-address1 wpforms-field-required\" name=\"wpforms[fields][4][address1]\" placeholder=\"Address Line 1\" required><label for=\"wpforms-4832-field_4\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Address Line 1<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div ><input type=\"text\" id=\"wpforms-4832-field_4-address2\" class=\"wpforms-field-address-address2\" name=\"wpforms[fields][4][address2]\" placeholder=\"Address Line 2\" ><label for=\"wpforms-4832-field_4-address2\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Address Line 2<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-4832-field_4-city\" class=\"wpforms-field-address-city wpforms-field-required\" name=\"wpforms[fields][4][city]\" placeholder=\"City\" required><label for=\"wpforms-4832-field_4-city\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">City<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-4832-field_4-state\" class=\"wpforms-field-address-state wpforms-field-required\" name=\"wpforms[fields][4][state]\" required><option class=\"placeholder\" value=\"\" selected disabled>State<\/option><option value=\"AL\" >Alabama<\/option><option value=\"AK\" >Alaska<\/option><option value=\"AZ\" >Arizona<\/option><option value=\"AR\" >Arkansas<\/option><option value=\"CA\" >California<\/option><option value=\"CO\" >Colorado<\/option><option value=\"CT\" >Connecticut<\/option><option value=\"DE\" >Delaware<\/option><option value=\"DC\" >District of Columbia<\/option><option value=\"FL\" >Florida<\/option><option value=\"GA\" >Georgia<\/option><option value=\"HI\" >Hawaii<\/option><option value=\"ID\" >Idaho<\/option><option value=\"IL\" >Illinois<\/option><option value=\"IN\" >Indiana<\/option><option value=\"IA\" >Iowa<\/option><option value=\"KS\" >Kansas<\/option><option value=\"KY\" >Kentucky<\/option><option value=\"LA\" >Louisiana<\/option><option value=\"ME\" >Maine<\/option><option value=\"MD\" >Maryland<\/option><option value=\"MA\" >Massachusetts<\/option><option value=\"MI\" >Michigan<\/option><option value=\"MN\" >Minnesota<\/option><option value=\"MS\" >Mississippi<\/option><option value=\"MO\" >Missouri<\/option><option value=\"MT\" >Montana<\/option><option value=\"NE\" >Nebraska<\/option><option value=\"NV\" >Nevada<\/option><option value=\"NH\" >New Hampshire<\/option><option value=\"NJ\" >New Jersey<\/option><option value=\"NM\" >New Mexico<\/option><option value=\"NY\" >New York<\/option><option value=\"NC\" >North Carolina<\/option><option value=\"ND\" >North Dakota<\/option><option value=\"OH\" >Ohio<\/option><option value=\"OK\" >Oklahoma<\/option><option value=\"OR\" >Oregon<\/option><option value=\"PA\" >Pennsylvania<\/option><option value=\"RI\" >Rhode Island<\/option><option value=\"SC\" >South Carolina<\/option><option value=\"SD\" >South Dakota<\/option><option value=\"TN\" >Tennessee<\/option><option value=\"TX\" >Texas<\/option><option value=\"UT\" >Utah<\/option><option value=\"VT\" >Vermont<\/option><option value=\"VA\" >Virginia<\/option><option value=\"WA\" >Washington<\/option><option value=\"WV\" >West Virginia<\/option><option value=\"WI\" >Wisconsin<\/option><option value=\"WY\" >Wyoming<\/option><\/select><label for=\"wpforms-4832-field_4-state\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">State<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-4832-field_4-postal\" class=\"wpforms-field-address-postal wpforms-field-required wpforms-masked-input\" data-inputmask-mask=\"(99999)|(99999-9999)\" data-inputmask-keepstatic=\"true\" data-rule-inputmask-incomplete=\"1\" name=\"wpforms[fields][4][postal]\" placeholder=\"Zip\" required><label for=\"wpforms-4832-field_4-postal\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Zip Code<\/label><\/div><\/div><\/div><div id=\"wpforms-4832-field_5-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"5\"><h3 id=\"wpforms-4832-field_5\">Autism Society Information<\/h3><\/div><div id=\"wpforms-4832-field_6-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-inline\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-4832-field_6\">Select which best fits your need <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-4832-field_6\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-4832-field_6_1\" name=\"wpforms[fields][6][]\" value=\"Parent of a child with autism\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_6_1\">Parent of a child with autism<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-4832-field_6_2\" name=\"wpforms[fields][6][]\" value=\"Individual with autism\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_6_2\">Individual with autism<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-4832-field_6_3\" name=\"wpforms[fields][6][]\" value=\"Family member of a person with autism\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_6_3\">Family member of a person with autism<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"checkbox\" id=\"wpforms-4832-field_6_6\" name=\"wpforms[fields][6][]\" value=\"Service provider\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_6_6\">Service provider<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"checkbox\" id=\"wpforms-4832-field_6_5\" name=\"wpforms[fields][6][]\" value=\"Medical professional\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_6_5\">Medical professional<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-4832-field_6_4\" name=\"wpforms[fields][6][]\" value=\"Educator\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_6_4\">Educator<\/label><\/li><li class=\"choice-7 depth-1\"><input type=\"checkbox\" id=\"wpforms-4832-field_6_7\" name=\"wpforms[fields][6][]\" value=\"Other\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_6_7\">Other<\/label><\/li><\/ul><\/div><div id=\"wpforms-4832-field_14-container\" class=\"wpforms-field wpforms-field-payment-multiple\" data-field-id=\"14\"><label class=\"wpforms-field-label\" for=\"wpforms-4832-field_14\">Preferred Language in Your Home <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-4832-field_14\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-4832-field_14_1\" class=\"wpforms-payment-price\" data-amount=\"10.00\" name=\"wpforms[fields][14]\" value=\"1\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_14_1\">English<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-4832-field_14_2\" class=\"wpforms-payment-price\" data-amount=\"25.00\" name=\"wpforms[fields][14]\" value=\"2\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_14_2\">Spanish<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-4832-field_14_3\" class=\"wpforms-payment-price\" data-amount=\"50.00\" name=\"wpforms[fields][14]\" value=\"3\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_14_3\">Other<\/label><\/li><\/ul><\/div><div id=\"wpforms-4832-field_15-container\" class=\"wpforms-field wpforms-field-payment-multiple\" data-field-id=\"15\"><label class=\"wpforms-field-label\" for=\"wpforms-4832-field_15\">Please share your ethnicity  <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-4832-field_15\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-4832-field_15_1\" class=\"wpforms-payment-price\" data-amount=\"0.00\" name=\"wpforms[fields][15]\" value=\"1\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_15_1\">Asian<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-4832-field_15_2\" class=\"wpforms-payment-price\" data-amount=\"0.00\" name=\"wpforms[fields][15]\" value=\"2\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_15_2\">Black\/ African American<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-4832-field_15_3\" class=\"wpforms-payment-price\" data-amount=\"0.00\" name=\"wpforms[fields][15]\" value=\"3\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_15_3\">Caucasian\/ White<\/label><\/li><li class=\"choice-4\"><input type=\"radio\" id=\"wpforms-4832-field_15_4\" class=\"wpforms-payment-price\" data-amount=\"0.00\" name=\"wpforms[fields][15]\" value=\"4\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_15_4\">Hispanic or Latino<\/label><\/li><li class=\"choice-5\"><input type=\"radio\" id=\"wpforms-4832-field_15_5\" class=\"wpforms-payment-price\" data-amount=\"0.00\" name=\"wpforms[fields][15]\" value=\"5\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_15_5\">Native American\/ Indigenous<\/label><\/li><li class=\"choice-6\"><input type=\"radio\" id=\"wpforms-4832-field_15_6\" class=\"wpforms-payment-price\" data-amount=\"0.00\" name=\"wpforms[fields][15]\" value=\"6\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_15_6\">Two or More Races<\/label><\/li><li class=\"choice-7\"><input type=\"radio\" id=\"wpforms-4832-field_15_7\" class=\"wpforms-payment-price\" data-amount=\"0.00\" name=\"wpforms[fields][15]\" value=\"7\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_15_7\">Other<\/label><\/li><li class=\"choice-8\"><input type=\"radio\" id=\"wpforms-4832-field_15_8\" class=\"wpforms-payment-price\" data-amount=\"0.00\" name=\"wpforms[fields][15]\" value=\"8\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_15_8\">Prefer not to answer<\/label><\/li><\/ul><\/div><div id=\"wpforms-4832-field_16-container\" class=\"wpforms-field wpforms-field-payment-multiple\" data-field-id=\"16\"><label class=\"wpforms-field-label\" for=\"wpforms-4832-field_16\">Check if you would like to stay informed: <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-4832-field_16\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-4832-field_16_1\" class=\"wpforms-payment-price\" data-amount=\"0.00\" name=\"wpforms[fields][16]\" value=\"1\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_16_1\">Add me to your mailing list<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-4832-field_16_2\" class=\"wpforms-payment-price\" data-amount=\"0.00\" name=\"wpforms[fields][16]\" value=\"2\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_16_2\">Add me to your email list<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-4832-field_16_3\" class=\"wpforms-payment-price\" data-amount=\"0.00\" name=\"wpforms[fields][16]\" value=\"3\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_16_3\">Add me to your list for Spanish speakers<\/label><\/li><\/ul><\/div><div id=\"wpforms-4832-field_17-container\" class=\"wpforms-field wpforms-field-payment-multiple\" data-field-id=\"17\"><label class=\"wpforms-field-label\" for=\"wpforms-4832-field_17\">How did you learn about us? (check all that apply): <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-4832-field_17\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-4832-field_17_1\" class=\"wpforms-payment-price\" data-amount=\"0.00\" name=\"wpforms[fields][17]\" value=\"1\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_17_1\">email<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-4832-field_17_2\" class=\"wpforms-payment-price\" data-amount=\"0.00\" name=\"wpforms[fields][17]\" value=\"2\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_17_2\">web search<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-4832-field_17_3\" class=\"wpforms-payment-price\" data-amount=\"0.00\" name=\"wpforms[fields][17]\" value=\"3\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_17_3\">social media<\/label><\/li><li class=\"choice-4\"><input type=\"radio\" id=\"wpforms-4832-field_17_4\" class=\"wpforms-payment-price\" data-amount=\"0.00\" name=\"wpforms[fields][17]\" value=\"4\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_17_4\">friend<\/label><\/li><li class=\"choice-5\"><input type=\"radio\" id=\"wpforms-4832-field_17_5\" class=\"wpforms-payment-price\" data-amount=\"0.00\" name=\"wpforms[fields][17]\" value=\"5\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_17_5\">news article<\/label><\/li><li class=\"choice-6\"><input type=\"radio\" id=\"wpforms-4832-field_17_6\" class=\"wpforms-payment-price\" data-amount=\"0.00\" name=\"wpforms[fields][17]\" value=\"6\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4832-field_17_6\">agency referral<\/label><\/li><\/ul><\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-field wpforms-field-hp\"><label for=\"wpforms-4832-field-hp\" class=\"wpforms-field-label\">Message<\/label><input type=\"text\" name=\"wpforms[hp]\" id=\"wpforms-4832-field-hp\" class=\"wpforms-field-medium\"><\/div><div class=\"wpforms-recaptcha-container wpforms-is-recaptcha wpforms-is-recaptcha-type-v3\" ><input type=\"hidden\" name=\"wpforms[recaptcha]\" value=\"\"><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"4832\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/scautism.org\/wp-json\/wp\/v2\/pages\/7765\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-4832\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><\/div><\/form><\/div>  <!-- .wpforms-container -->\n\t\t\t\t<\/div>\n\t\t\t<\/div><\/p>\n","protected":false},"author":12,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"[wpforms id=\"4832\"]","_et_gb_content_width":"","footnotes":""},"_links":{"self":[{"href":"https:\/\/scautism.org\/wp-json\/wp\/v2\/pages\/7765"}],"collection":[{"href":"https:\/\/scautism.org\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/scautism.org\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/scautism.org\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/scautism.org\/wp-json\/wp\/v2\/comments?post=7765"}],"version-history":[{"count":6,"href":"https:\/\/scautism.org\/wp-json\/wp\/v2\/pages\/7765\/revisions"}],"predecessor-version":[{"id":7829,"href":"https:\/\/scautism.org\/wp-json\/wp\/v2\/pages\/7765\/revisions\/7829"}],"wp:attachment":[{"href":"https:\/\/scautism.org\/wp-json\/wp\/v2\/media?parent=7765"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}