{"id":49778,"date":"2025-05-28T17:21:20","date_gmt":"2025-05-28T21:21:20","guid":{"rendered":"https:\/\/jesusreyeslaw.com\/?page_id=49778"},"modified":"2025-05-28T17:25:17","modified_gmt":"2025-05-28T21:25:17","slug":"intake-legal-consultation","status":"publish","type":"page","link":"https:\/\/jesusreyeslaw.com\/en\/intake-legal-consultation\/","title":{"rendered":"Intake Legal Consultation"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"49778\" class=\"elementor elementor-49778 elementor-36480\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-a4e5091 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"a4e5091\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2344efc\" data-id=\"2344efc\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-e14fc9b elementor-widget elementor-widget-image\" data-id=\"e14fc9b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"300\" height=\"300\" src=\"https:\/\/jesusreyeslaw.com\/wp-content\/uploads\/2020\/10\/logo-footer.webp\" class=\"attachment-medium size-medium wp-image-9162\" alt=\"Law Office of Jesus Reyes\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-85ecc66 elementor-widget elementor-widget-heading\" data-id=\"85ecc66\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">EMAIL CONSULTATION FORM<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a732229 elementor-widget elementor-widget-text-editor\" data-id=\"a732229\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>LAW OFFICE OF JESUS REYES<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-bff962f elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"bff962f\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-e6ee5e4\" data-id=\"e6ee5e4\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-310c397 elementor-widget elementor-widget-shortcode\" data-id=\"310c397\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><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 gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_9' style='display:none'>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Intake (English)<\/h2>\n                            <p class='gform_description'>Please fill out and submit the following form in order to process your legal inquiry. Required fields must be completed. If any do not apply to you, please enter \"N\/A\" or \"not applicable\".<\/p>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_custom\">(Required)<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_9'  action='\/en\/wp-json\/wp\/v2\/pages\/49778' data-formid='9' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_9' class='gform_fields top_label form_sublabel_above description_above validation_above'><div id=\"field_9_1\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Applicant&#039;s information<\/h3><\/div><fieldset id=\"field_9_21\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name has_middle_name has_last_name no_suffix gf_name_has_3 ginput_container_name gform-grid-row' id='input_9_21'>\n                            \n                            <span id='input_9_21_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_9_21_3' class='gform-field-label gform-field-label--type-sub '>First name<\/label>\n                                                    <input type='text' name='input_21.3' id='input_9_21_3' value=''   aria-required='true'     \/>\n                                                <\/span>\n                            <span id='input_9_21_4_container' class='name_middle gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_9_21_4' class='gform-field-label gform-field-label--type-sub '>Middle name<\/label>\n                                                    <input type='text' name='input_21.4' id='input_9_21_4' value=''   aria-required='false'     \/>\n                                                <\/span>\n                            <span id='input_9_21_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_9_21_6' class='gform-field-label gform-field-label--type-sub '>Last names<\/label>\n                                                            <input type='text' name='input_21.6' id='input_9_21_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_9_5\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_5'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_5' id='input_9_5' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_9_4\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_above gfield--has-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_4'>Citizenship<\/label><div class='gfield_description' id='gfield_description_9_4'>Applicant's nationality<\/div><div class='ginput_container ginput_container_text'><input name='input_4' id='input_9_4' type='text' value='' class='medium'  aria-describedby=\"gfield_description_9_4\"    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_6\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_6'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_6' id='input_9_6' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_63\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Genre<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_63'>\n\t\t\t<div class='gchoice gchoice_9_63_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_63' type='radio' value='Man'  id='choice_9_63_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_63_0' id='label_9_63_0' class='gform-field-label gform-field-label--type-inline'>Man<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_63_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_63' type='radio' value='Woman'  id='choice_9_63_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_63_1' id='label_9_63_1' class='gform-field-label gform-field-label--type-inline'>Woman<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_8\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-half gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_8'>Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_8'>Applicant's Date of Birth<\/div><div class='ginput_container ginput_container_date'>\n                            <input name='input_8' id='input_9_8' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_9_8_date_format gfield_description_9_8\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_9_8_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_9_8' class='gform_hidden' value='https:\/\/jesusreyeslaw.com\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><fieldset id=\"field_9_71\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you or a family member a client of Law Office of Jesus Reyes?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_71'>\n\t\t\t<div class='gchoice gchoice_9_71_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_71' type='radio' value='YES'  id='choice_9_71_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_71_0' id='label_9_71_0' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_71_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_71' type='radio' value='NO'  id='choice_9_71_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_71_1' id='label_9_71_1' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_72\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_72'>First Name and Last Name of the family member who is a client of the firm. (If you are the client, put \u201cI\u201d)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_72' id='input_9_72' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_68\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Alien Number<\/h3><\/div><fieldset id=\"field_9_69\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Select one of the following options:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_69'>\n\t\t\t<div class='gchoice gchoice_9_69_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='Yes, I have Alien number and I know it.'  id='choice_9_69_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_69_0' id='label_9_69_0' class='gform-field-label gform-field-label--type-inline'>Yes, I have Alien number and I know it.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_69_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='I have been assigned an Alien number, but I do not have\/know it.'  id='choice_9_69_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_69_1' id='label_9_69_1' class='gform-field-label gform-field-label--type-inline'>I have been assigned an Alien number, but I do not have\/know it.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_69_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='I have never been assigned an Alien number.'  id='choice_9_69_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_69_2' id='label_9_69_2' class='gform-field-label gform-field-label--type-inline'>I have never been assigned an Alien number.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_12\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_12'>What is your Alien number?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_12'>If you have ever been assigned an immigrant or \"Alien\" number, please provide it.<\/div><div class='ginput_container ginput_container_text'><input name='input_12' id='input_9_12' type='text' value='' class='medium'  aria-describedby=\"gfield_description_9_12\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_7\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_7'>Where is the applicant currently located?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_7' id='input_9_7' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_70\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><h3 class=\"gsection_title\">USA entrance<\/h3><\/div><div id=\"field_9_9\" 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_above gfield--has-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_9'>Admission Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_9'>Date of admission (or entry) into the United States. If you have not entered the U.S., select today's date.<\/div><div class='ginput_container ginput_container_date'>\n                            <input name='input_9' id='input_9_9' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_9_9_date_format gfield_description_9_9\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_9_9_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_9_9' class='gform_hidden' value='https:\/\/jesusreyeslaw.com\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_9_11\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_11'>Method of entry to the USA (If applicable)<\/label><div class='gfield_description' id='gfield_description_9_11'>Entry through a U.S. port or airport, Type of Visa, Unauthorized (Border)? Please describe your type of entry to the U.S. (if applicable).<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_11' id='input_9_11' class='textarea large'  aria-describedby=\"gfield_description_9_11\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_9_48\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Did you enter the United States with a Visa or Parole?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_48'>\n\t\t\t<div class='gchoice gchoice_9_48_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_48' type='radio' value='YES'  id='choice_9_48_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_48_0' id='label_9_48_0' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_48_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_48' type='radio' value='NO'  id='choice_9_48_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_48_1' id='label_9_48_1' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_49\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_49'>If so, with which visa or Parole did you enter the United States?<\/label><div class='gfield_description' id='gfield_description_9_49'>Please specify the type of visa or parole with which you are entering the USA.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_49' id='input_9_49' class='textarea large'  aria-describedby=\"gfield_description_9_49\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_64\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Arrests<\/h3><\/div><fieldset id=\"field_9_57\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you have any arrests?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_57'>\n\t\t\t<div class='gchoice gchoice_9_57_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_57' type='radio' value='YES'  id='choice_9_57_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_57_0' id='label_9_57_0' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_57_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_57' type='radio' value='NO'  id='choice_9_57_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_57_1' id='label_9_57_1' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_58\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_58'>If you were arrested, what was the reason why?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_58' id='input_9_58' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_59\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_59'>If arrested, were you later convicted?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_59' id='input_9_59' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_60\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_60'>When did the arrest take place?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_60' id='input_9_60' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_61\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_61'>Was the matter resolved? If so, how?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_61' id='input_9_61' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_62\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_62'>More details about the arrest \/ conviction<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_62' id='input_9_62' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_65\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Immigration Processes<\/h3><\/div><div id=\"field_9_14\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_14'>Have you ever done any immigration paperwork in the United States or at a U.S. consulate?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_14'>Please describe your procedure. If you have not had any, simply write \"NO\".<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_14' id='input_9_14' class='textarea large'  aria-describedby=\"gfield_description_9_14\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_15\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_15'>Have you ever had an immigration court proceeding in the U.S.? What was the result?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_15'>If you have had please describe, if not, simply write \"NO\". <\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_15' id='input_9_15' class='textarea large'  aria-describedby=\"gfield_description_9_15\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_16\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_16'>Have you ever been deported from the United States?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_16'>(Either by a border officer or by an immigration judge). If you have been deported, please describe and date. If not, simply write \"NO\".<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_16' id='input_9_16' class='textarea large'  aria-describedby=\"gfield_description_9_16\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_17\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_17'>Have you ever been a victim of crime in the United States?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_17'> Please describe the crime and the facts. If not, simply write \"NO\". <\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_17' id='input_9_17' class='textarea large'  aria-describedby=\"gfield_description_9_17\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_9_50\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you been a victim of an automobile accident in the United States?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_50'>\n\t\t\t<div class='gchoice gchoice_9_50_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='YES'  id='choice_9_50_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_50_0' id='label_9_50_0' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_50_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='NO'  id='choice_9_50_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_50_1' id='label_9_50_1' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_52\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >If so, are you already represented by such an accident?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_52'>\n\t\t\t<div class='gchoice gchoice_9_52_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_52' type='radio' value='YES'  id='choice_9_52_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_52_0' id='label_9_52_0' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_52_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_52' type='radio' value='NO'  id='choice_9_52_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_52_1' id='label_9_52_1' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_53\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_53'>Please describe the accident:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_53' id='input_9_53' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_9_54\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >In addition to immigration legal advice, do you need assistance in any non-immigration legal matters?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_54'>\n\t\t\t<div class='gchoice gchoice_9_54_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_54' type='radio' value='YES'  id='choice_9_54_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_54_0' id='label_9_54_0' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_54_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_54' type='radio' value='NO'  id='choice_9_54_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_54_1' id='label_9_54_1' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_55\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_55'>If so, please describe your legal need.<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_55' id='input_9_55' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_18\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Your company information<\/h3><\/div><fieldset id=\"field_9_20\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you have a business in your country?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_20'>\n\t\t\t<div class='gchoice gchoice_9_20_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='YES'  id='choice_9_20_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_20_0' id='label_9_20_0' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_20_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='NO'  id='choice_9_20_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_20_1' id='label_9_20_1' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_22\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_22'>How many employees do you have?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_9_22' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_23\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_23'>How many years has your company been in operation?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_9_23' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_25\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_25'>What does your company do? Please describe...<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_25' id='input_9_25' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_26\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Studies<\/h3><\/div><div id=\"field_9_27\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_27'>Do you have any college degree and\/or work experience?<\/label><div class='gfield_description' id='gfield_description_9_27'>Please describe. If you do not have a title, simply write \"NO\".<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_27' id='input_9_27' class='textarea large'  aria-describedby=\"gfield_description_9_27\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_28\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Relatives<\/h3><\/div><fieldset id=\"field_9_29\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you have family members in the United States who have legal status?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_29'>\n\t\t\t<div class='gchoice gchoice_9_29_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='YES'  id='choice_9_29_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_29_0' id='label_9_29_0' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_29_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='NO'  id='choice_9_29_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_29_1' id='label_9_29_1' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_31\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><pr>If yes, please answer the following questions:<\/pr><\/div><div id=\"field_9_32\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_32'>Who are the family members?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_32' id='input_9_32' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_33\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_33'>What is their relationship with you?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_33' id='input_9_33' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_34\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_34'>What is the status of your family members in the U.S.?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_34' id='input_9_34' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_66\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you have a parent, spouse or child serving in the U.S. military?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_66'>\n\t\t\t<div class='gchoice gchoice_9_66_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_66' type='radio' value='YES'  id='choice_9_66_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_66_0' id='label_9_66_0' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_66_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_66' type='radio' value='NO'  id='choice_9_66_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_66_1' id='label_9_66_1' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_35\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_35'>If yes, please describe.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_35' id='input_9_35' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_9_36\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Based on your knowledge, do you know if any of these family members suffer from any medical conditions?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_36'>\n\t\t\t<div class='gchoice gchoice_9_36_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='YES'  id='choice_9_36_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_36_0' id='label_9_36_0' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_36_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='NO'  id='choice_9_36_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_36_1' id='label_9_36_1' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_37\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you married?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_37'>\n\t\t\t<div class='gchoice gchoice_9_37_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='YES'  id='choice_9_37_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_37_0' id='label_9_37_0' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_37_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='NO'  id='choice_9_37_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_37_1' id='label_9_37_1' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_38\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you have children?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_38'>\n\t\t\t<div class='gchoice gchoice_9_38_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='YES'  id='choice_9_38_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_38_0' id='label_9_38_0' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_38_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='NO'  id='choice_9_38_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_38_1' id='label_9_38_1' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_39\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_39'>If you have children, please list the names, ages and nationalities of each of your children.<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_39' id='input_9_39' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_40\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Applicable Reliefs<\/h3><\/div><fieldset id=\"field_9_41\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you afraid to return to your country?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_41'>\n\t\t\t<div class='gchoice gchoice_9_41_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_41' type='radio' value='YES'  id='choice_9_41_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_41_0' id='label_9_41_0' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_41_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_41' type='radio' value='NO'  id='choice_9_41_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_41_1' id='label_9_41_1' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_42\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you been a victim of persecution in your country for any of the following reasons?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_42'>\n\t\t\t<div class='gchoice gchoice_9_42_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='Policy'  id='choice_9_42_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_42_0' id='label_9_42_0' class='gform-field-label gform-field-label--type-inline'>Policy<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_42_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='Religion'  id='choice_9_42_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_42_1' id='label_9_42_1' class='gform-field-label gform-field-label--type-inline'>Religion<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_42_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='By nationality'  id='choice_9_42_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_42_2' id='label_9_42_2' class='gform-field-label gform-field-label--type-inline'>By nationality<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_42_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='By race'  id='choice_9_42_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_42_3' id='label_9_42_3' class='gform-field-label gform-field-label--type-inline'>By race<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_42_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='For being part of a particular marginalized group protected under the law.'  id='choice_9_42_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_42_4' id='label_9_42_4' class='gform-field-label gform-field-label--type-inline'>For being part of a particular marginalized group protected under the law.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_42_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='NOT APPLICABLE'  id='choice_9_42_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_42_5' id='label_9_42_5' class='gform-field-label gform-field-label--type-inline'>NOT APPLICABLE<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_43\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_43'>Have you had any persecution problems in that country?<\/label><div class='gfield_description' id='gfield_description_9_43'>Please describe your case in detail.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_43' id='input_9_43' class='textarea large'  aria-describedby=\"gfield_description_9_43\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_73\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Third Country<\/h3><\/div><fieldset id=\"field_9_44\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you obtained any legal status in a third country?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_44'>\n\t\t\t<div class='gchoice gchoice_9_44_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='YES'  id='choice_9_44_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_44_0' id='label_9_44_0' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_44_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='NO'  id='choice_9_44_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_44_1' id='label_9_44_1' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_45\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_45'>If so, what status did you obtain in that country?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_45' id='input_9_45' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_46\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Consultation<\/h3><\/div><div id=\"field_9_47\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_47'>What is your inquiry?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_47'>Please explain in detail the reason for your inquiry. The more details the better, so that we can advise you effectively.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_47' id='input_9_47' class='textarea large'  aria-describedby=\"gfield_description_9_47\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_9' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Send'  \/> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_9' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_9' id='gform_theme_9' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_9' 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