{"id":2682,"date":"2024-02-12T10:32:32","date_gmt":"2024-02-12T10:32:32","guid":{"rendered":"https:\/\/heartitout.in\/career-form\/?page_id=2682"},"modified":"2024-04-26T11:42:55","modified_gmt":"2024-04-26T11:42:55","slug":"application-form-for-junior-counselling-psychologist","status":"publish","type":"page","link":"https:\/\/heartitout.in\/career-form\/application-form-for-junior-counselling-psychologist\/","title":{"rendered":"Application Form for Junior Counselling Psychologist"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"2682\" class=\"elementor elementor-2682\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-section elementor-top-section elementor-element elementor-element-40647a5 elementor-section-full_width elementor-section-height-default elementor-section-height-default\" data-id=\"40647a5\" data-element_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-287093b\" data-id=\"287093b\" data-element_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-b0fe53b elementor-widget__width-inherit elementor-widget elementor-widget-html\" data-id=\"b0fe53b\" data-element_type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t   <!-- Google Tag Manager (noscript) -->\n   <noscript><iframe src=\"https:\/\/www.googletagmanager.com\/ns.html?id=GTM-56CS6TH\" height=\"0\" width=\"0\"\n         style=\"display:none;visibility:hidden\"><\/iframe><\/noscript>\n   <!-- End Google Tag Manager (noscript) -->\n   <!--............... start header section ...............-->\n   <header 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class=\"nav-link dropdown-toggle\" href=\"#\" id=\"navbarDropdown\" role=\"button\"\n                        data-bs-toggle=\"dropdown\" aria-expanded=\"false\">\n                        SERVICES\n                     <\/a>\n                     <ul class=\"dropdown-menu\" aria-labelledby=\"navbarDropdown\">\n                        <li><a class=\"dropdown-item\" href=\"https:\/\/heartitout.in\/individual-therapy\/\">Individual\n                              Therapy<\/a>\n                        <\/li>\n                        <li><a class=\"dropdown-item\" href=\"https:\/\/heartitout.in\/couples-therapy\/\">Couples Therapy<\/a>\n                        <\/li>\n                        <li><a class=\"dropdown-item\" href=\"https:\/\/heartitout.in\/family-therapy\/\">Family Therapy<\/a>\n                        <\/li>\n                        <li><a class=\"dropdown-item\" href=\"https:\/\/heartitout.in\/child-therapy\/\">Child Therapy<\/a><\/li>\n                        <li><a 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href=\"https:\/\/heartitout.in\/events\" target=\"_blank\">EVENTS<\/a>\n                  <\/li>\n\n                  <li class=\"nav-item\">\n                     <a class=\"nav-link \" aria-current=\"page\" href=\"\/corporate\/\" target=\"_blank\">CORPORATE<\/a>\n                  <\/li>\n\n\n                  <li class=\"nav-item d-none\">\n                     <a class=\"nav-link\" href=\"https:\/\/heartitout.in\/events\/\">EVENTS<\/a>\n                  <\/li>\n\n\n                  <li class=\"nav-item\">\n\n                     <a class=\"nav-link\" href=\"https:\/\/heartitout.in\/about-us\/\" target=\"_blank\">ABOUT <\/a>\n                  <\/li>\n                  <li class=\"nav-item d-none\">\n                     <a class=\"nav-link\" href=\"https:\/\/heartitout.in\/blogs\/\">BLOG<\/a>\n                  <\/li>\n                  <li class=\"nav-item\">\n\n                     <a class=\"nav-link\" href=\"https:\/\/heartitout.in\/careers\/\" target=\"_blank\">CAREERS<\/a>\n                  <\/li>\n\n                  <li class=\"nav-item\">\n                     <a class=\"btn btn_pri d-block\" href=\"https:\/\/heartitout.in\/welcome\/\" target=\"_blank\">LOGIN \/ SIGN UP<\/a>\n                  <\/li>\n               <\/ul>\n            <\/div>\n         <\/div>\n      <\/nav>\n   <\/header>\n   <!--............... end header section ...............-->\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 data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-section elementor-top-section elementor-element elementor-element-fbde1c9 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"fbde1c9\" data-element_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-c44f717\" data-id=\"c44f717\" data-element_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-3d9f760 elementor-widget elementor-widget-heading\" data-id=\"3d9f760\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">Application Form for Junior Counselling Psychologist<\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d130d25 elementor-widget elementor-widget-text-editor\" data-id=\"d130d25\" data-element_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>Hello Humans! Welcome to the application form for the position of Counselling Psychologist at Heart it Out. We are pleased to see that you are interested to be joining our family \ud83d\ude42 Do take out 5 minutes of your time to fill out this application and we will get back to you as soon as possible. Have a great day!<\/p>\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-f34c683 elementor-button-align-center elementor-widget__width-inherit elementor-widget elementor-widget-form\" data-id=\"f34c683\" data-element_type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;dce_confirm_dialog_enabled&quot;:&quot;no&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;,&quot;label_icon_size&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;field_icon_size&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]}}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"dce-conditions-js-error-notice elementor-message elementor-message-danger\" style=\"display: none;\">A problem was detected in the following Form. Submitting it could result in errors. Please contact the site administrator.<\/div>\t\t\t<script>\n\t\t\tsetTimeout(function() {\n\t\t\t\tlet el = document.querySelector(\".dce-conditions-js-error-notice\");\n\t\t\t\tif (el)\n\t\t\t\t\tel.style.display = \"block\";\n\t\t\t}, 6000);\n\t\t\t<\/script>\t\t<form class=\"elementor-form\" method=\"post\" name=\"Application Form for Junior Counselling Psychologist\u200b\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"2682\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"f34c683\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"\" \/>\n\n\t\t\t\n\t\t\t<div data-field-conditions=\"[{&quot;id&quot;:&quot;languages_others&quot;,&quot;condition&quot;:&quot;(languages == \\&quot;Other\\&quot;)&quot;,&quot;mode&quot;:&quot;show&quot;,&quot;disableOnly&quot;:false}]\" data-field-ids=\"[&quot;email_id&quot;,&quot;whats_ur_name&quot;,&quot;birthday_date&quot;,&quot;gender_identify&quot;,&quot;your_pronouns&quot;,&quot;currently_reside&quot;,&quot;contact_num&quot;,&quot;languages&quot;,&quot;languages_others&quot;,&quot;cv&quot;,&quot;visit&quot;,&quot;graduate_school&quot;,&quot;undergraduate_school&quot;,&quot;find&quot;,&quot;counselling_psychologist&quot;,&quot;therapy_plan_to_practice&quot;,&quot;primarily_inclined_towards&quot;,&quot;mental_health&quot;,&quot;committed_to_projects&quot;,&quot;undergoing_therapy&quot;,&quot;field_b358a5c&quot;,&quot;name_reference&quot;,&quot;awesome_human&quot;,&quot;contact_them&quot;,&quot;any_other_references&quot;]\" class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email_id elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-email_id\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tEmail\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[email_id]\" id=\"form-field-email_id\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Your email address\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-whats_ur_name elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-whats_ur_name\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHi! What's your name?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[whats_ur_name]\" id=\"form-field-whats_ur_name\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-date elementor-field-group elementor-column elementor-field-group-birthday_date elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-birthday_date\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWhen is your birthday?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[birthday_date]\" id=\"form-field-birthday_date\" class=\"elementor-field elementor-size-sm  elementor-field-textual elementor-date-field\" required=\"required\" aria-required=\"true\" pattern=\"[0-9]{4}-[0-9]{2}-[0-9]{2}\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-gender_identify elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-gender_identify\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWhich gender do you identify with?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[gender_identify]\" id=\"form-field-gender_identify\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-your_pronouns elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-your_pronouns\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWhat are your pronouns?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[your_pronouns]\" id=\"form-field-your_pronouns\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-currently_reside elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-currently_reside\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWhere do you currently reside?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[currently_reside]\" id=\"form-field-currently_reside\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-contact_num elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-contact_num\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWhat is your contact number\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[contact_num]\" id=\"form-field-contact_num\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" aria-required=\"true\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-languages elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-languages\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWhich languages are you comfortable with?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"English\" id=\"form-field-languages-0\" name=\"form_fields[languages][]\"> <label for=\"form-field-languages-0\">English<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Hindi\" id=\"form-field-languages-1\" name=\"form_fields[languages][]\"> <label for=\"form-field-languages-1\">Hindi<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Kannada\" id=\"form-field-languages-2\" name=\"form_fields[languages][]\"> <label for=\"form-field-languages-2\">Kannada<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Other\" id=\"form-field-languages-3\" name=\"form_fields[languages][]\"> <label for=\"form-field-languages-3\">Other<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-languages_others elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-languages_others\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWhich languages are you comfortable with?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[languages_others]\" id=\"form-field-languages_others\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-upload elementor-field-group elementor-column elementor-field-group-cv elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-cv\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCV\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input type=\"file\" name=\"form_fields[cv]\" id=\"form-field-cv\" class=\"elementor-field elementor-size-sm  elementor-upload-field\" required=\"required\" aria-required=\"true\" data-maxsize=\"2\" data-maxsize-message=\"This file exceeds the maximum allowed size.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-visit elementor-col-100\">\n\t\t\t\t\t<h1 style=\"text-align:center; color:#01818C;\">Educational Qualification<\/h1>\n\t<p style=\"text-align:center;color:#01818C;\">Tell us where you studied and the amazing things you have done there! Here is a sample of how you need to write the information under each question:\n\t<br>\n\t1. Name of the institution -<br>\n\t2.  Name of Degree awarded -<br>\n\t3.  Subjects -<br>\n\t4.  Year of Completion\/Duration -<br>\n\tFeel free to add major awards, recognition and other tidbits. It will take 5 minutes approximately.\n\t\n\t \n\t<\/p>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-graduate_school elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-graduate_school\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tGraduate School Information\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[graduate_school]\" id=\"form-field-graduate_school\" rows=\"4\" required=\"required\" aria-required=\"true\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-undergraduate_school elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-undergraduate_school\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tUndergraduate School Information\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[undergraduate_school]\" id=\"form-field-undergraduate_school\" rows=\"4\" required=\"required\" aria-required=\"true\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-find elementor-col-100\">\n\t\t\t\t\t\t<h1 style=\"text-align:center; color:#01818C;\">Counseling Psychologist Details<\/h1>\n\t<p style=\"text-align:center;color:#01818C;\"> Here are some questions to help us understand a little more about why you are looking out for this job!<\/p>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-counselling_psychologist elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-counselling_psychologist\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWhat, according to you, would make you a good Counselling Psychologist at Heart It Out?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[counselling_psychologist]\" id=\"form-field-counselling_psychologist\" rows=\"4\" required=\"required\" aria-required=\"true\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-therapy_plan_to_practice elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-therapy_plan_to_practice\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWhat kind of therapy do you practice\/ plan to practice?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[therapy_plan_to_practice]\" id=\"form-field-therapy_plan_to_practice\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-primarily_inclined_towards elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-primarily_inclined_towards\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWhich school of thought are you primarily inclined towards?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[primarily_inclined_towards]\" id=\"form-field-primarily_inclined_towards\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-mental_health elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-mental_health\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWhat does mental health mean to you?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[mental_health]\" id=\"form-field-mental_health\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-committed_to_projects elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-committed_to_projects\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAre you currently committed to any professional projects\/ work?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[committed_to_projects]\" id=\"form-field-committed_to_projects\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-undergoing_therapy elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-undergoing_therapy\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAre you currently undergoing therapy?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-undergoing_therapy-0\" name=\"form_fields[undergoing_therapy]\" required=\"required\" aria-required=\"true\"> <label for=\"form-field-undergoing_therapy-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-undergoing_therapy-1\" name=\"form_fields[undergoing_therapy]\" required=\"required\" aria-required=\"true\"> <label for=\"form-field-undergoing_therapy-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_b358a5c elementor-col-100\">\n\t\t\t\t\t\t<h1 style=\"text-align:center; color:#01818C;\">References<\/h1>\n\t<p style=\"text-align:center;color:#01818C;\"> Psst...tell us who thinks you are amazing \ud83d\ude42<\/p>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-name_reference elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-name_reference\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tName of Reference\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[name_reference]\" id=\"form-field-name_reference\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-awesome_human elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-awesome_human\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWhere did you meet this awesome human?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[awesome_human]\" id=\"form-field-awesome_human\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-contact_them elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-contact_them\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHow can we contact them?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[contact_them]\" id=\"form-field-contact_them\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-any_other_references elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-any_other_references\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAny other References?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[any_other_references]\" id=\"form-field-any_other_references\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-sm\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Send<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\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 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