{"id":9540,"date":"2025-02-19T12:57:39","date_gmt":"2025-02-19T20:57:39","guid":{"rendered":"https:\/\/extension.wsu.edu\/sanjuan\/?page_id=9540"},"modified":"2025-03-18T12:23:23","modified_gmt":"2025-03-18T19:23:23","slug":"care-to-share-form","status":"publish","type":"page","link":"https:\/\/extension.wsu.edu\/sanjuan\/4h\/care-to-share-form\/","title":{"rendered":"&#8220;Care to Share&#8221; Form"},"content":{"rendered":"<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_gecko gform_wrapper gravity-theme' id='gform_wrapper_14' >\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">San Juan County 4-H &#8220;Care to Share&#8221; Form<\/h2>\n                            <span class='gform_description'>This form has been designed to provide valuable input to the San Juan 4-H program. Once completed, this form will be distributed to the appropriate individual or group to address the issue or concern.Please take a few moments and complete all three sections of this form and sign it. <b> Forms without all three sections completed and a signature will be disregarded. <\/b><\/span>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_14'  action='\/sanjuan\/wp-json\/wp\/v2\/pages\/9540' >\n                        <div class='gform_body gform-body'><div id='gform_fields_14' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_14_1\"  class=\"gfield field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_14_1\"><label class='gfield_label' for='input_14_1' >Section #1: Describe the current situation:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_1' id='input_14_1' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_14_3\"  class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_14_3\"><label class='gfield_label' for='input_14_3' >Section #2: Describe the problem with the current situation:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_3' id='input_14_3' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_14_4\"  class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_14_4\"><label class='gfield_label' for='input_14_4' >Section #3: Give your suggestion(s) for a possible solution:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_4' id='input_14_4' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_14_5\"  class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_14_5\"><legend class='gfield_label gfield_label_before_complex'  >Name<\/legend><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_14_5'>\n                            \n                            <span id='input_14_5_3_container' class='name_first' >\n                                                    <input type='text' name='input_5.3' id='input_14_5_3' value=''   aria-required='false'     \/>\n                                                    <label for='input_14_5_3' >First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_14_5_6_container' class='name_last' >\n                                                    <input type='text' name='input_5.6' id='input_14_5_6' value=''   aria-required='false'     \/>\n                                                    <label for='input_14_5_6' >Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_14_6\"  class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_14_6\"><legend class='gfield_label gfield_label_before_complex'  >Address<\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address' id='input_14_6' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1' id='input_14_6_1_container' >\n                                        <input type='text' name='input_6.1' id='input_14_6_1' value=''    aria-required='false'    \/>\n                                        <label for='input_14_6_1' id='input_14_6_1_label' >Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2' id='input_14_6_2_container' >\n                                        <input type='text' name='input_6.2' id='input_14_6_2' value=''     aria-required='false'   \/>\n                                        <label for='input_14_6_2' id='input_14_6_2_label' >Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city' id='input_14_6_3_container' >\n                                    <input type='text' name='input_6.3' id='input_14_6_3' value=''    aria-required='false'    \/>\n                                    <label for='input_14_6_3' id='input_14_6_3_label' >City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state' id='input_14_6_4_container' >\n                                        <input type='text' name='input_6.4' id='input_14_6_4' value=''      aria-required='false'    \/>\n                                        <label for='input_14_6_4' id='input_14_6_4_label' >State \/ Province \/ Region<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip' id='input_14_6_5_container' >\n                                    <input type='text' name='input_6.5' id='input_14_6_5' value=''    aria-required='false'    \/>\n                                    <label for='input_14_6_5' id='input_14_6_5_label' >ZIP \/ Postal Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_6.6' id='input_14_6_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_14_7\"  class=\"gfield gfield--width-five-twelfths 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gfield_label_before_complex'  >Consent<\/legend><div class='ginput_container ginput_container_consent'><input name='input_9.1' id='input_14_9_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_14_9 gfield_description_14_9\"  aria-invalid=\"false\"   \/> <label class=\"gfield_consent_label\" for='input_14_9_1' >I Agree<\/label><input type='hidden' name='input_9.2' value='I Agree' class='gform_hidden' \/><input type='hidden' name='input_9.3' value='6' class='gform_hidden' \/><\/div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_14_9'>By clicking &#8220;I Agree,&#8221; you acknowledge that you are the individual submitting this form and that the content of the form is accurate and correct to the best of your knowledge. You understand and agree that this completed form constitutes the entire agreement between you and San Juan County 4-H. You intend to sign this agreement electronically, and your click serves as your legally binding electronic signature.<\/div><\/fieldset><div id=\"field_14_11\"  class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_14_11\"><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_14_10\"  class=\"gfield gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_14_10\">Created by John DeMontmollin (2009) Revised in 2011 by Dan Teuteberg. \n<br> <i> Extension programs are available to all without discrimination. 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