{"id":1550,"date":"2019-03-13T19:00:07","date_gmt":"2019-03-13T19:00:07","guid":{"rendered":"https:\/\/domsafety.com\/contractors\/?page_id=1550"},"modified":"2025-06-30T19:00:20","modified_gmt":"2025-06-30T19:00:20","slug":"order-worker-safety-training-materials-elec-and-gas","status":"publish","type":"page","link":"https:\/\/domsafety.com\/contractors\/order-worker-safety-training-materials-elec-and-gas\/","title":{"rendered":"Order your FREE safety training materials &#8211; elec and gas"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last fusion-column-no-min-height\" style=\"--awb-bg-size:cover;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-column-content-centered\"><div class=\"fusion-column-content\"><div class=\"fusion-text fusion-text-1\"><div class=\"fusion-text\">\n<h1>Order your FREE\u00a0English and\/or Spanish safety training materials<\/h1>\n<\/div>\n<\/div><div class=\"fusion-image-element in-legacy-container\" style=\"--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><span class=\" fusion-imageframe imageframe-none imageframe-1 hover-type-none\"><img decoding=\"async\" width=\"1304\" height=\"566\" alt=\"Order free materials cmb slide 2\" title=\"Order free materials cmb slide 2\" src=\"https:\/\/domsafety.com\/contractors\/wp-content\/uploads\/2025\/06\/Order_free_materials_cmb_slide_2.jpg\" class=\"img-responsive wp-image-3987\" srcset=\"https:\/\/domsafety.com\/contractors\/wp-content\/uploads\/2025\/06\/Order_free_materials_cmb_slide_2-200x87.jpg 200w, https:\/\/domsafety.com\/contractors\/wp-content\/uploads\/2025\/06\/Order_free_materials_cmb_slide_2-400x174.jpg 400w, https:\/\/domsafety.com\/contractors\/wp-content\/uploads\/2025\/06\/Order_free_materials_cmb_slide_2-600x260.jpg 600w, https:\/\/domsafety.com\/contractors\/wp-content\/uploads\/2025\/06\/Order_free_materials_cmb_slide_2-800x347.jpg 800w, https:\/\/domsafety.com\/contractors\/wp-content\/uploads\/2025\/06\/Order_free_materials_cmb_slide_2-1200x521.jpg 1200w, https:\/\/domsafety.com\/contractors\/wp-content\/uploads\/2025\/06\/Order_free_materials_cmb_slide_2.jpg 1304w\" sizes=\"(max-width: 800px) 100vw, 1200px\" \/><\/span><\/div><div class=\"accordian fusion-accordian\" style=\"--awb-border-size:1px;--awb-icon-size:13px;--awb-content-font-size:15px;--awb-icon-alignment:left;--awb-hover-color:#e0e0e0;--awb-border-color:#dbdbdb;--awb-background-color:#ededed;--awb-divider-color:#e0dede;--awb-divider-hover-color:#e0dede;--awb-icon-color:#ffffff;--awb-title-color:#0072ce;--awb-content-color:#000000;--awb-icon-box-color:#0072ce;--awb-toggle-hover-accent-color:#009639;--awb-title-font-family:Arial, Helvetica, sans-serif;--awb-title-font-weight:700;--awb-title-font-style:normal;--awb-content-font-family:Arial, Helvetica, sans-serif;--awb-content-font-style:normal;--awb-content-font-weight:400;\"><div class=\"panel-group fusion-toggle-icon-boxed\" id=\"accordion-1550-1\"><div class=\"fusion-panel panel-default panel-1c641639adba3bbd0 fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:#0072ce;--awb-content-color:#000000;\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_1c641639adba3bbd0\"><a aria-expanded=\"false\" aria-controls=\"1c641639adba3bbd0\" role=\"button\" data-toggle=\"collapse\" data-target=\"#1c641639adba3bbd0\" href=\"#1c641639adba3bbd0\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon awb-icon-plus\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Free English and\/or Spanish kit includes<\/span><\/a><\/h4><\/div><div id=\"1c641639adba3bbd0\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_1c641639adba3bbd0\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><strong><span style=\"color: #00148c;\"><i class=\"fb-icon-element-1 fb-icon-element fontawesome-icon fa fa-check circle-yes fusion-text-flow\" style=\"--awb-iconcolor:#d3d3d3;--awb-iconcolor-hover:#d3d3d3;--awb-circlecolor:#00148c;--awb-circlecolor-hover:#00148c;--awb-circlebordersize:1px;--awb-font-size:11.44px;--awb-width:22.88px;--awb-height:22.88px;--awb-line-height:20.88px;--awb-margin-right:6.5px;\"><\/i>10 <em>Worker Beware<sup>\u00ae<\/sup><\/em> booklets \/ 10 Libros de <em>T<\/em><em>rabajador est\u00e9 atento<\/em><\/span><\/strong><\/p>\n<p style=\"padding-left: 30px; margin-top: -15px;\"><span style=\"font-weight: 400;\">Use these eight-page booklets featuring full-color photos to train your employees to follow key tips for working safely around electric or natural gas utilities.<\/span><\/p>\n<p><strong><span style=\"color: #00148c;\"><i class=\"fb-icon-element-2 fb-icon-element fontawesome-icon fa fa-check circle-yes fusion-text-flow\" style=\"--awb-iconcolor:#d3d3d3;--awb-iconcolor-hover:#d3d3d3;--awb-circlecolor:#00148c;--awb-circlecolor-hover:#00148c;--awb-circlebordersize:1px;--awb-font-size:11.44px;--awb-width:22.88px;--awb-height:22.88px;--awb-line-height:20.88px;--awb-margin-right:6.5px;\"><\/i>10 <\/span><\/strong><span style=\"color: #00148c;\"><strong class=\"plarge\"><strong><em>Worker Beware<\/em><\/strong>\u00a0visor cards \/ <\/strong><\/span><strong><span style=\"color: #00148c;\">10 Tarjetas para parasol de\u00a0<em>Trabajador est\u00e9 atento<\/em><\/span><\/strong><\/p>\n<p style=\"padding-left: 30px; margin-top: -15px;\"><span style=\"font-weight: 400;\">Encourage workers to keep this visor card in their vehicles as a quick reference to help prevent accidents around electric or natural gas utilities on the job site. It also covers what to do in the event of a power line or pipeline contact.<\/span><\/p>\n<p><strong><span style=\"color: #00148c;\"><i class=\"fb-icon-element-3 fb-icon-element fontawesome-icon fa fa-check circle-yes fusion-text-flow\" style=\"--awb-iconcolor:#d3d3d3;--awb-iconcolor-hover:#d3d3d3;--awb-circlecolor:#00148c;--awb-circlecolor-hover:#00148c;--awb-circlebordersize:1px;--awb-font-size:11.44px;--awb-width:22.88px;--awb-height:22.88px;--awb-line-height:20.88px;--awb-margin-right:6.5px;\"><\/i><\/span><\/strong><span style=\"color: #00148c;\"><strong class=\"plarge\"><strong>10<em> Worker Beware<\/em><\/strong> wallet cards \/ 10 Tarjetas de cartera <em>Trabajador est\u00e9 atento*<\/em><\/strong><\/span><\/p>\n<p style=\"padding-left: 30px; margin-top: -15px;\"><span style=\"font-weight: 400;\">Be sure every worker has this handy guide of life-saving electrical and natural gas safety tips to carry with them at all times<\/span>.<\/p>\n<p><span style=\"color: #00148c;\"><strong>How to order:<\/strong><\/span><br \/>\nSimply complete the online order form below, then click the \u201cOrder\u201d button. Orders are filled on a first-come, first-served basis. Please allow 2-4 weeks for delivery.<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"--awb-bg-size:cover;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-2\"><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\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\/* ]]> *\/\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_25' style='display:none'>\n                        <div class='gform_heading'>\n                            <p class='gform_description'><p><strong>To help you teach employees how to work safely around electric and natural gas lines, we\u2019re pleased to offer you a <span style=\"color: red;\">FREE<\/span> safety training kit.<\/strong> Simply complete the order form below. Orders are filled on a first-come, first-served basis.<\/p><\/p>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_25'  action='\/contractors\/wp-json\/wp\/v2\/pages\/1550' data-formid='25' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_25' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_25_102\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gf_list_2col gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Please select your Safety Training Materials:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_25_102'><div class='gchoice gchoice_25_102_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_102.1' type='checkbox'  value='1'  id='choice_25_102_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_102_1' id='label_25_102_1' class='gform-field-label gform-field-label--type-inline'>Worker Beware Electric - English<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_102_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_102.2' type='checkbox'  value='1'  id='choice_25_102_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_102_2' id='label_25_102_2' class='gform-field-label gform-field-label--type-inline'>Worker Beware Electric - Spanish<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_102_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_102.3' type='checkbox'  value='1'  id='choice_25_102_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_102_3' id='label_25_102_3' class='gform-field-label gform-field-label--type-inline'>Worker Beware Gas - English<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_102_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_102.4' type='checkbox'  value='1'  id='choice_25_102_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_102_4' id='label_25_102_4' class='gform-field-label gform-field-label--type-inline'>Worker Beware Gas - Spanish<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_25_98\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_25_38\" class=\"gfield gfield--type-html gfield--input-type-html gf_2col gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><strong>1. Where should we mail your FREE safety materials?<br>\n<em>\u00bfA d\u00f3nde desea que le enviemos sus folletos de seguridad GRATUITOS?<\/em><\/strong><\/div><div id=\"field_25_105\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_25_105'>First name \/ Nombre:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_105' id='input_25_105' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_25_106\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_25_106'>Last name \/ Apellido:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_106' id='input_25_106' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_25_4\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_25_4'>Title \/ Puesto:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_25_4' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_25_5\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_25_5'>Company \/ Compa\u00f1\u00eda:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_25_5' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_25_30\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_25_30'>Mailing address \/ Direcci\u00f3n:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_30' id='input_25_30' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_25_33\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_25_33'>City \/ Ciudad:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_33' id='input_25_33' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_25_41\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label screen-reader-text gfield_label_before_complex' ><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_25_41'><div class='gchoice gchoice_25_41_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.1' type='checkbox'  value='on'  id='choice_25_41_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_41_1' id='label_25_41_1' class='gform-field-label gform-field-label--type-inline'>Check if this is a home address. \/ Marque si es una direcci\u00f3n particular.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_25_34\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_25_34'>State \/ Estado:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_34' id='input_25_34' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>-- Select a state --<\/option><option value='NC' >North Carolina<\/option><option value='SC' >South Carolina<\/option><option value='TX' >Texas<\/option><option value='VA' >Virginia<\/option><\/select><\/div><\/div><div id=\"field_25_32\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_25_32'>ZIP code \/ C\u00f3digo postal:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_32' id='input_25_32' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_25_15\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_25_15'>Phone \/ Tel\u00e9fono:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_15' id='input_25_15' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_25_16\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_25_16'>Email \/ Correo electr\u00f3nico:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_16' id='input_25_16' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_25_17\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_3col field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >3. Number of employees (including owner): \/ Cantidad de empleados (incluyendo el due\u00f1o):<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_25_17'>\n\t\t\t<div class='gchoice gchoice_25_17_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='0-5'  id='choice_25_17_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_17_0' id='label_25_17_0' class='gform-field-label gform-field-label--type-inline'>0-5<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_17_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='6-10'  id='choice_25_17_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_17_1' id='label_25_17_1' class='gform-field-label gform-field-label--type-inline'>6-10<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_17_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='11-20'  id='choice_25_17_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_17_2' id='label_25_17_2' class='gform-field-label gform-field-label--type-inline'>11-20<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_17_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='21-50'  id='choice_25_17_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_17_3' id='label_25_17_3' class='gform-field-label gform-field-label--type-inline'>21-50<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_17_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='51+'  id='choice_25_17_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_17_4' id='label_25_17_4' class='gform-field-label gform-field-label--type-inline'>51+<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_17_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='NA'  id='choice_25_17_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_17_5' id='label_25_17_5' class='gform-field-label gform-field-label--type-inline'>NA<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_25_19\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gf_list_3col field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >4. What is your primary business? (Check all that apply.)  \/  \u00bfCu\u00e1l es la actividad principal de su negocio? (Marque todos los que apliquen.)<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_25_19'><div class='gchoice gchoice_25_19_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.1' type='checkbox'  value='Aerial'  id='choice_25_19_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_1' id='label_25_19_1' class='gform-field-label gform-field-label--type-inline'>Aerial<br><em>A\u00e9reo<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.2' type='checkbox'  value='Agriculture'  id='choice_25_19_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_2' id='label_25_19_2' class='gform-field-label gform-field-label--type-inline'>Agriculture<br><em>Agricultura<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.3' type='checkbox'  value='Carpentry'  id='choice_25_19_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_3' id='label_25_19_3' class='gform-field-label gform-field-label--type-inline'>Carpentry<br><em>Carpinter\u00eda<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.4' type='checkbox'  value='Cement\/Concrete and Masonry'  id='choice_25_19_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_4' id='label_25_19_4' class='gform-field-label gform-field-label--type-inline'>Cement\/Concrete and Masonry<br><em>Cemento\/Concreto y Alba\u00f1iler\u00eda<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.5' type='checkbox'  value='Construction'  id='choice_25_19_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_5' id='label_25_19_5' class='gform-field-label gform-field-label--type-inline'>Construction<br><em>Construcci\u00f3n<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.6' type='checkbox'  value='Drilling (Water, Well)'  id='choice_25_19_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_6' id='label_25_19_6' class='gform-field-label gform-field-label--type-inline'>Drilling (Water, Well)<br><em>Perforaci\u00f3n (Agua, Pozos)<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.7' type='checkbox'  value='Electrical'  id='choice_25_19_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_7' id='label_25_19_7' class='gform-field-label gform-field-label--type-inline'>Electrical<br><em>Electricidad<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.8' type='checkbox'  value='Equipment Rental'  id='choice_25_19_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_8' id='label_25_19_8' class='gform-field-label gform-field-label--type-inline'>Equipment Rental<br><em>Alquiler de equipos<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.9' type='checkbox'  value='Excavation'  id='choice_25_19_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_9' id='label_25_19_9' class='gform-field-label gform-field-label--type-inline'>Excavation<br><em>Excavaci\u00f3n<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.11' type='checkbox'  value='Farming'  id='choice_25_19_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_11' id='label_25_19_11' class='gform-field-label gform-field-label--type-inline'>Farming<br><em>Ganader\u00eda<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.12' type='checkbox'  value='Farm Labor Contractor'  id='choice_25_19_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_12' id='label_25_19_12' class='gform-field-label gform-field-label--type-inline'>Farm Labor Contractor<br><em>Contratista agr\u00edcola<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.13' type='checkbox'  value='Farm Supply Services'  id='choice_25_19_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_13' id='label_25_19_13' class='gform-field-label gform-field-label--type-inline'>Farm Supply Services<br><em>Servicios de insumos  agr\u00edcolas<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.14' type='checkbox'  value='General Contractor'  id='choice_25_19_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_14' id='label_25_19_14' class='gform-field-label gform-field-label--type-inline'>General Contractor<br><em>Contratista general<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.15' type='checkbox'  value='HVAC'  id='choice_25_19_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_15' id='label_25_19_15' class='gform-field-label gform-field-label--type-inline'>HVAC<br><em>Calefacci\u00f3n, Ventilaci\u00f3n y Aire Acondicionado<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.16' type='checkbox'  value='Landscaping'  id='choice_25_19_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_16' id='label_25_19_16' class='gform-field-label gform-field-label--type-inline'>Landscaping<br><em>Jardiner\u00eda<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_17'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.17' type='checkbox'  value='Mechanical'  id='choice_25_19_17'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_17' id='label_25_19_17' class='gform-field-label gform-field-label--type-inline'>Mechanical<br><em>Mec\u00e1nico<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_18'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.18' type='checkbox'  value='Nursery'  id='choice_25_19_18'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_18' id='label_25_19_18' class='gform-field-label gform-field-label--type-inline'>Nursery<br><em>Vivero<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_19'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.19' type='checkbox'  value='Painting'  id='choice_25_19_19'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_19' id='label_25_19_19' class='gform-field-label gform-field-label--type-inline'>Painting<br><em>Pintura<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_21'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.21' type='checkbox'  value='Paving'  id='choice_25_19_21'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_21' id='label_25_19_21' class='gform-field-label gform-field-label--type-inline'>Paving<br><em>Pavimentaci\u00f3n<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_22'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.22' type='checkbox'  value='Plumbing'  id='choice_25_19_22'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_22' id='label_25_19_22' class='gform-field-label gform-field-label--type-inline'>Plumbing<br><em>Plomer\u00eda<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_23'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.23' type='checkbox'  value='Remodeling\/Additions'  id='choice_25_19_23'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_23' id='label_25_19_23' class='gform-field-label gform-field-label--type-inline'>Remodeling\/Additions<br><em>Remodelaci\u00f3n\/Ampliaciones<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_24'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.24' type='checkbox'  value='Road Construction'  id='choice_25_19_24'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_24' id='label_25_19_24' class='gform-field-label gform-field-label--type-inline'>Road Construction<br><em>Construcci\u00f3n de carreteras<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_25'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.25' type='checkbox'  value='Roofing\/Siding'  id='choice_25_19_25'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_25' id='label_25_19_25' class='gform-field-label gform-field-label--type-inline'>Roofing\/Siding<br><em>Techos\/Medianeras<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_26'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.26' type='checkbox'  value='Telecom\/Cable'  id='choice_25_19_26'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_26' id='label_25_19_26' class='gform-field-label gform-field-label--type-inline'>Telecom\/Cable<br><em>Telecomunicaci\u00f3n\/Cable<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_27'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.27' type='checkbox'  value='Tree Trimming'  id='choice_25_19_27'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_27' id='label_25_19_27' class='gform-field-label gform-field-label--type-inline'>Tree Trimming<br><em>Poda de \u00e1rboles<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_28'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.28' type='checkbox'  value='Utility Work'  id='choice_25_19_28'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_28' id='label_25_19_28' class='gform-field-label gform-field-label--type-inline'>Utility Work<br><em>Trabajo de Servicios P\u00fablicos<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_19_29'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.29' type='checkbox'  value='Other (please explain) \/ Otro (favor de explicar):'  id='choice_25_19_29'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_19_29' id='label_25_19_29' class='gform-field-label gform-field-label--type-inline'>Other (please explain):<br> <em>Otro (explicar):<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_25_20\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_25_20'>Primary business \u2013 Other (please explain): \/ \u00bfCu\u00e1l es la actividad principal de su negocio? (Marque todos los que apliquen.)<\/label><div class='ginput_container ginput_container_text'><input name='input_20' id='input_25_20' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_25_42\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gf_list_3col field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >5. How will you use these safety materials? (Check all that apply.) \/ \u00bfC\u00f3mo usar\u00e1 este material de capacitaci\u00f3n sobre seguridad? (Marque todas las opciones que apliquen.)<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_25_42'><div class='gchoice gchoice_25_42_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.1' type='checkbox'  value='Safety meeting\/training'  id='choice_25_42_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_42_1' id='label_25_42_1' class='gform-field-label gform-field-label--type-inline'>Safety meeting\/training<br><em>Reuni\u00f3n\/capacitaci\u00f3n de seguridad<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_42_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.2' type='checkbox'  value='Tailgate\/job site meeting'  id='choice_25_42_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_42_2' id='label_25_42_2' class='gform-field-label gform-field-label--type-inline'>Tailgate\/job site meeting<br><em>Reuni\u00f3n de seguridad en el sitio de trabajo<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_42_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.3' type='checkbox'  value='New employee\/orientation training'  id='choice_25_42_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_42_3' id='label_25_42_3' class='gform-field-label gform-field-label--type-inline'>New employee\/orientation training<br><em>Capacitaci\u00f3n\/orientaci\u00f3n de empleados<br> nuevos<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_42_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.4' type='checkbox'  value='Personal knowledge'  id='choice_25_42_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_42_4' id='label_25_42_4' class='gform-field-label gform-field-label--type-inline'>Personal knowledge<br><em>Conocimientos personales<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_42_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.5' type='checkbox'  value='Customer knowledge'  id='choice_25_42_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_42_5' id='label_25_42_5' class='gform-field-label gform-field-label--type-inline'>Customer knowledge<br><em>Conocimientos del cliente<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_42_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.6' type='checkbox'  value='Other (please explain) \/ Otro (favor de explicar):'  id='choice_25_42_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_42_6' id='label_25_42_6' class='gform-field-label gform-field-label--type-inline'>Other (please explain):<br><em>Otro (explicar):<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_25_43\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_25_43'>Other (please explain) \/ Otro (favor de explicar):<\/label><div class='ginput_container ginput_container_text'><input name='input_43' id='input_25_43' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_25_44\" class=\"gfield gfield--type-textarea gfield--input-type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_25_44'>6. What do you feel are the most important safety topics that need to be covered in training materials? \/ \u00bfCu\u00e1les son los temas de seguridad m\u00e1s importantes que a su criterio deben cubrirse en el material de capacitaci\u00f3n?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_44' id='input_25_44' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_25_47\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><strong>7. How much do you agree with each of the following statements? \/ \u00bfCu\u00e1n de acuerdo est\u00e1 con cada una de las siguientes afirmaciones?<\/strong><\/div><fieldset id=\"field_25_49\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_5col field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Dominion Energy is committed to the safety of workers like me. \/ Dominion Energy est\u00e1 comprometida con la seguridad de los trabajadores.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_25_49'>\n\t\t\t<div class='gchoice gchoice_25_49_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='Strongly agree'  id='choice_25_49_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_49_0' id='label_25_49_0' class='gform-field-label gform-field-label--type-inline'>Strongly agree<br><em>Muy de acuerdo<\/em><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_49_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='Agree'  id='choice_25_49_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_49_1' id='label_25_49_1' class='gform-field-label gform-field-label--type-inline'>Agree<br><em>De acuerdo<\/em><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_49_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='Neither agree nor disagree'  id='choice_25_49_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_49_2' id='label_25_49_2' class='gform-field-label gform-field-label--type-inline'>Neither agree nor disagree<br><em>Ni de acuerdo ni en desacuerdo <\/em><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_49_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='Disagree'  id='choice_25_49_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_49_3' id='label_25_49_3' class='gform-field-label gform-field-label--type-inline'>Disagree<br><em>En desacuerdo<\/em><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_49_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='Strongly disagree'  id='choice_25_49_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_49_4' id='label_25_49_4' class='gform-field-label gform-field-label--type-inline'>Strongly disagree<br><em> Muy en desacuerdo <\/em><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_25_96\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_5col field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >The information Dominion Energy provides is valuable for keeping workers safe around electricity and\/or natural gas. \/ La informaci\u00f3n suministrada por Dominion Energy es muy valiosa para cuidar la seguridad de los trabajadores de mi sector al trabajar con electricidad y\/o gas natural.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_25_96'>\n\t\t\t<div class='gchoice gchoice_25_96_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_96' type='radio' value='Strongly agree'  id='choice_25_96_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_96_0' id='label_25_96_0' class='gform-field-label gform-field-label--type-inline'>Strongly agree<br><em>Muy de acuerdo<\/em><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_96_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_96' type='radio' value='Agree'  id='choice_25_96_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_96_1' id='label_25_96_1' class='gform-field-label gform-field-label--type-inline'>Agree<br><em>De acuerdo<\/em><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_96_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_96' type='radio' value='Neither agree nor disagree'  id='choice_25_96_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_96_2' id='label_25_96_2' class='gform-field-label gform-field-label--type-inline'>Neither agree nor disagree<br><em>Ni de acuerdo ni en desacuerdo <\/em><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_96_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_96' type='radio' value='Disagree'  id='choice_25_96_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_96_3' id='label_25_96_3' class='gform-field-label gform-field-label--type-inline'>Disagree<br><em>En desacuerdo<\/em><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_96_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_96' type='radio' value='Strongly disagree'  id='choice_25_96_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_96_4' id='label_25_96_4' class='gform-field-label gform-field-label--type-inline'>Strongly disagree<br><em> Muy en desacuerdo <\/em><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_25_50\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_5col field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >I expect Dominion Energy to provide workers the information necessary to get their jobs done safely around Dominion Energy&#039;s electric and\/or natural gas infrastructure. \/ Espero que Dominion Energy suministre a los trabajadores la informaci\u00f3n que necesitan para realizar sus tareas de manera segura cerca de la infraestructura el\u00e9ctrica y\/o de gas natural de Dominion Energy.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_25_50'>\n\t\t\t<div class='gchoice gchoice_25_50_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='Strongly agree'  id='choice_25_50_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_50_0' id='label_25_50_0' class='gform-field-label gform-field-label--type-inline'>Strongly agree<br><em>Muy de acuerdo<\/em><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_50_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='Agree'  id='choice_25_50_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_50_1' id='label_25_50_1' class='gform-field-label gform-field-label--type-inline'>Agree<br><em>De acuerdo<\/em><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_50_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='Neither agree nor disagree'  id='choice_25_50_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_50_2' id='label_25_50_2' class='gform-field-label gform-field-label--type-inline'>Neither agree nor disagree<br><em>Ni de acuerdo ni en desacuerdo <\/em><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_50_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='Disagree'  id='choice_25_50_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_50_3' id='label_25_50_3' class='gform-field-label gform-field-label--type-inline'>Disagree<br><em>En desacuerdo<\/em><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_50_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='Strongly disagree'  id='choice_25_50_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_50_4' id='label_25_50_4' class='gform-field-label gform-field-label--type-inline'>Strongly disagree<br><em> Muy en desacuerdo <\/em><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_25_51\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_5col field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >The workers at my company use the Dominion Energy safety information to work more safely around electricity and\/or natural gas. \/ Los trabajadores de mi empresa utilizan la informaci\u00f3guridad para trabajar con mayor seguridad cerca de las instalaciones el\u00e9ctricas y\/o de gas natural.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_25_51'>\n\t\t\t<div class='gchoice gchoice_25_51_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_51' type='radio' value='Strongly agree'  id='choice_25_51_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_51_0' id='label_25_51_0' class='gform-field-label gform-field-label--type-inline'>Strongly agree<br><em>Muy de acuerdo<\/em><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_51_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_51' type='radio' value='Agree'  id='choice_25_51_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_51_1' id='label_25_51_1' class='gform-field-label gform-field-label--type-inline'>Agree<br><em>De acuerdo<\/em><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_51_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_51' type='radio' value='Neither agree nor disagree'  id='choice_25_51_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_51_2' id='label_25_51_2' class='gform-field-label gform-field-label--type-inline'>Neither agree nor disagree<br><em>Ni de acuerdo ni en desacuerdo <\/em><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_51_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_51' type='radio' value='Disagree'  id='choice_25_51_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_51_3' id='label_25_51_3' class='gform-field-label gform-field-label--type-inline'>Disagree<br><em>En desacuerdo<\/em><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_51_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_51' type='radio' value='Strongly disagree'  id='choice_25_51_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_51_4' id='label_25_51_4' class='gform-field-label gform-field-label--type-inline'>Strongly disagree<br><em> Muy en desacuerdo <\/em><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_25_52\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_5col field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >The worker materials provided by Dominion Energy help me and\/or my coworkers perform our jobs more safely. \/ Los trabajadores de mi empresa utilizan la informaci\u00f3n de seguridad para trabajar con mayor seguridad cerca de las instalaciones el\u00e9ctricas y\/o de gas natural.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_25_52'>\n\t\t\t<div class='gchoice gchoice_25_52_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_52' type='radio' value='Strongly agree'  id='choice_25_52_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_52_0' id='label_25_52_0' class='gform-field-label gform-field-label--type-inline'>Strongly agree<br><em>Muy de acuerdo<\/em><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_52_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_52' type='radio' value='Agree'  id='choice_25_52_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_52_1' id='label_25_52_1' class='gform-field-label gform-field-label--type-inline'>Agree<br><em>De acuerdo<\/em><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_52_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_52' type='radio' value='Neither agree nor disagree'  id='choice_25_52_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_52_2' id='label_25_52_2' class='gform-field-label gform-field-label--type-inline'>Neither agree nor disagree<br><em>Ni de acuerdo ni en desacuerdo <\/em><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_52_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_52' type='radio' value='Disagree'  id='choice_25_52_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_52_3' id='label_25_52_3' class='gform-field-label gform-field-label--type-inline'>Disagree<br><em>En desacuerdo<\/em><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_52_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_52' type='radio' value='Strongly disagree'  id='choice_25_52_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_52_4' id='label_25_52_4' class='gform-field-label gform-field-label--type-inline'>Strongly disagree<br><em> Muy en desacuerdo <\/em><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_25_53\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_5col field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >8. Years company has been in business: \/ A\u00f1os de actividad de la compa\u00f1\u00eda:<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_25_53'>\n\t\t\t<div class='gchoice gchoice_25_53_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_53' type='radio' value='0-5'  id='choice_25_53_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_53_0' id='label_25_53_0' class='gform-field-label gform-field-label--type-inline'>0-5<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_53_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_53' type='radio' value='6-10'  id='choice_25_53_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_53_1' id='label_25_53_1' class='gform-field-label gform-field-label--type-inline'>6-10<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_53_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_53' type='radio' value='11-20'  id='choice_25_53_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_53_2' id='label_25_53_2' class='gform-field-label gform-field-label--type-inline'>11-20<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_53_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_53' type='radio' value='21-50'  id='choice_25_53_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_53_3' id='label_25_53_3' class='gform-field-label gform-field-label--type-inline'>21-50<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_53_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_53' type='radio' value='51+'  id='choice_25_53_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_53_4' id='label_25_53_4' class='gform-field-label gform-field-label--type-inline'>51+<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_25_55\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_25_55'>9. Is there another language that would be beneficial to have the materials in? \/ \u00bfPiensa que ser\u00eda bueno tener este material en alg\u00fan otro idioma?<\/label><div class='ginput_container ginput_container_text'><input name='input_55' id='input_25_55' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_25_75\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gf_list_3col field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >10. How did you hear about the Dominion Energy At-Risk Worker Safety Outreach Program? \/ \u00bfC\u00f3mo se enter\u00f3 del Programa de Difusi\u00f3n de Seguridad para Trabajadores en Riesgo de Dominion Energy?<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_25_75'><div class='gchoice gchoice_25_75_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_75.1' type='checkbox'  value='Coworker'  id='choice_25_75_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_75_1' id='label_25_75_1' class='gform-field-label gform-field-label--type-inline'>Coworker<br><em>Compa\u00f1ero de trabajo<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_75_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_75.2' type='checkbox'  value='Email'  id='choice_25_75_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_75_2' id='label_25_75_2' class='gform-field-label gform-field-label--type-inline'>Email<br><em>Correo electr\u00f3nico<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_75_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_75.3' type='checkbox'  value='Direct mail'  id='choice_25_75_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_75_3' id='label_25_75_3' class='gform-field-label gform-field-label--type-inline'>Direct mail<br><em>Correo directo<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_75_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_75.4' type='checkbox'  value='Dominion Energy employee'  id='choice_25_75_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_75_4' id='label_25_75_4' class='gform-field-label gform-field-label--type-inline'>Dominion Energy employee<br><em>Empleado de Dominion Energy<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_25_75_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_75.5' type='checkbox'  value='Other (please explain)'  id='choice_25_75_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_25_75_5' id='label_25_75_5' class='gform-field-label gform-field-label--type-inline'>Other (please explain)<br><em>Otro (explicar):<\/em><\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_25_80\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_25_80'>How did you hear about us- Other (please explain) \/ Orto (favor de explicar):<\/label><div class='ginput_container ginput_container_text'><input name='input_80' id='input_25_80' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_25_57\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style=\"padding: 10px; background-color: #CCC;\">\n<span style=\"color: #FFF;\">Internal use only \/ S\u00f3lo para uso interno<\/span>\n<\/div><\/div><div id=\"field_25_56\" class=\"gfield gfield--type-text gfield--input-type-text gf_inline gfield_label_gray field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_25_56'>ID<\/label><div class='ginput_container ginput_container_text'><input name='input_56' id='input_25_56' type='text' value='' class='small'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_25_58\" class=\"gfield gfield--type-text gfield--input-type-text gf_inline gfield_label_gray field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_25_58'>BRC code<\/label><div class='ginput_container ginput_container_text'><input name='input_58' id='input_25_58' type='text' value='' class='small'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_25_60\" class=\"gfield gfield--type-text gfield--input-type-text gf_inline gfield_label_gray field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_25_60'>Date (mm\/dd\/yy)<\/label><div class='ginput_container ginput_container_text'><input name='input_60' id='input_25_60' type='text' value='' class='small'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_25_116\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_25_116'>How many kits are needed for this order?<\/label><div class='ginput_container ginput_container_select'><select name='input_116' id='input_25_116' class='small gfield_select'     aria-invalid=\"false\" ><option value='0' selected='selected'>1<\/option><option value='1' >2<\/option><option value='2' >3<\/option><option value='3' >4<\/option><\/select><\/div><\/div><div id=\"field_25_69\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_69' id='input_25_69' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='8068' \/><\/div><\/div><fieldset id=\"field_25_104\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><legend class='gfield_label gform-field-label' >project_category<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_25_104'>\n\t\t\t<div class='gchoice gchoice_25_104_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_104' type='radio' value='school'  id='choice_25_104_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_104_0' id='label_25_104_0' class='gform-field-label gform-field-label--type-inline'>school<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_104_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_104' type='radio' value='contractor' checked='checked' id='choice_25_104_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_104_1' id='label_25_104_1' class='gform-field-label gform-field-label--type-inline'>contractor<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_104_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_104' type='radio' value='first responder'  id='choice_25_104_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_104_2' id='label_25_104_2' class='gform-field-label gform-field-label--type-inline'>first responder<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_104_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_104' type='radio' value='other'  id='choice_25_104_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_104_3' id='label_25_104_3' class='gform-field-label gform-field-label--type-inline'>other<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_25_107\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_107' id='input_25_107' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_25_108\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_108' id='input_25_108' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_25_109\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_109' id='input_25_109' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_25_110\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_110' id='input_25_110' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='https:\/\/domsafety.com\/contractors\/order-worker-safety-training-materials-elec-and-gas\/' \/><\/div><\/div><div id=\"field_25_112\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_calculation field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_25_112'>P79315<\/label><div class='ginput_container ginput_container_number'><input name='input_112' id='input_25_112' type='text' step='any'   value='' class='large gform-text-input-reset'  readonly=\"readonly\"    aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_25_113\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_calculation field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_25_113'>P79310<\/label><div class='ginput_container ginput_container_number'><input name='input_113' id='input_25_113' type='text' step='any'   value='' class='large gform-text-input-reset'  readonly=\"readonly\"    aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_25_114\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_calculation field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_25_114'>P79320<\/label><div class='ginput_container ginput_container_number'><input name='input_114' id='input_25_114' type='text' step='any'   value='' class='large gform-text-input-reset'  readonly=\"readonly\"    aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_25_115\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_calculation field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_25_115'>P79325<\/label><div class='ginput_container ginput_container_number'><input name='input_115' id='input_25_115' type='text' step='any'   value='' class='large gform-text-input-reset'  readonly=\"readonly\"    aria-invalid=\"false\"  \/><\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_25' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='ORDER \/ PEDIDO'  \/> \n            <input type='hidden' 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kit.<\/strong> Orders are filled on a first-come, first-served basis.<\/p>\n<p><strong><span style=\"color: #ff00ff;\">The 2023 program is now closed. Please check back in 2024 for the new program.<\/span><\/strong><\/p>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":13,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1550","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/domsafety.com\/contractors\/wp-json\/wp\/v2\/pages\/1550","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/domsafety.com\/contractors\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/domsafety.com\/contractors\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/domsafety.com\/contractors\/wp-json\/wp\/v2\/users\/13"}],"replies":[{"embeddable":true,"href":"https:\/\/domsafety.com\/contractors\/wp-json\/wp\/v2\/comments?post=1550"}],"version-history":[{"count":99,"href":"https:\/\/domsafety.com\/contractors\/wp-json\/wp\/v2\/pages\/1550\/revisions"}],"predecessor-version":[{"id":3988,"href":"https:\/\/domsafety.com\/contractors\/wp-json\/wp\/v2\/pages\/1550\/revisions\/3988"}],"wp:attachment":[{"href":"https:\/\/domsafety.com\/contractors\/wp-json\/wp\/v2\/media?parent=1550"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}