{"id":1145,"date":"2025-05-27T21:44:41","date_gmt":"2025-05-27T21:44:41","guid":{"rendered":"https:\/\/forms.westernu.edu\/students\/?page_id=1145"},"modified":"2025-06-11T20:23:49","modified_gmt":"2025-06-11T20:23:49","slug":"club-name-change-request","status":"publish","type":"page","link":"https:\/\/forms.westernu.edu\/students\/club-name-change-request\/","title":{"rendered":"Club Name Change Request"},"content":{"rendered":"<h2>\u00a0<\/h2>\n<h2>This form is to be completed by club leaders who wish to request a name change for officially recognized club.\u00a0<\/h2>\n<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_69' style='display:none'><form method='post' enctype='multipart\/form-data'  id='gform_69'  action='\/students\/wp-json\/wp\/v2\/pages\/1145' data-formid='69' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_69' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_8\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><br \/>\n<br \/>\n<br \/>\n<br \/><\/div><fieldset id=\"field_69_1\" class=\"gfield gfield--type-name gfield--input-type-name 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' >Requestor&#039;s Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_69_1'>\n                            \n                            <span id='input_69_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_69_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_69_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_69_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_69_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_69_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_69_23\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><br \/>\n<br \/>\n<br \/>\n<br \/><\/div><div id=\"field_69_4\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_4'>Requestor&#039;s Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_4' id='input_69_4' type='email' value='' class='large'   placeholder='@westernu.edu' aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_69_4\" \/>\n                        <\/div><div class='gfield_description' id='gfield_description_69_4'>Must be @westernu.edu e-mail address<\/div><\/div><div id=\"field_69_16\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><br \/>\n<br \/>\n<br \/>\n<br \/><\/div><fieldset id=\"field_69_7\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full 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' >Campus<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_7'>\n\t\t\t<div class='gchoice gchoice_69_7_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='Pomona'  id='choice_69_7_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_7_0' id='label_69_7_0' class='gform-field-label gform-field-label--type-inline'>Pomona<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_7_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='Lebanon'  id='choice_69_7_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_7_1' id='label_69_7_1' class='gform-field-label gform-field-label--type-inline'>Lebanon<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_69_17\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><br \/>\n<br \/>\n<br \/>\n<br \/><\/div><div id=\"field_69_5\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full 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_69_5'>Club&#039;s Current Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_5' id='input_69_5' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='SELECT ONE' >SELECT ONE<\/option><option value='Academy of General Dentistry' >Academy of General Dentistry<\/option><option value='Academy of Managed Care Pharmacy' >Academy of Managed Care Pharmacy<\/option><option value='American Academy of Podiatric Practice Management (AAPPM)' >American Academy of Podiatric Practice Management (AAPPM)<\/option><option value='American Academy of Podiatric Sports Medicine' >American Academy of Podiatric Sports Medicine<\/option><option value='American Assembly for Men in Nursing' >American Assembly for Men in Nursing<\/option><option value='American Association of Public Health Dentistry at WesternU' >American Association of Public Health Dentistry at WesternU<\/option><option value='American Association of Women Dentists' >American Association of Women Dentists<\/option><option value='American Association of Women Podiatrists' >American Association of Women Podiatrists<\/option><option value='American College of Foot &amp; Ankle Surgeons' >American College of Foot &amp; Ankle Surgeons<\/option><option value='American College of Osteopathic Family Physicians' >American College of Osteopathic Family Physicians<\/option><option value='American College of Osteopathic Family Physicians-Lebanon' >American College of Osteopathic Family Physicians-Lebanon<\/option><option value='American College of Osteopathic Pediatricians-Lebanon' >American College of Osteopathic Pediatricians-Lebanon<\/option><option value='American College of Osteopathic Surgeons' >American College of Osteopathic Surgeons<\/option><option value='American College of Podiatric Medicine' >American College of Podiatric Medicine<\/option><option value='American Dental Education Association' >American Dental Education Association<\/option><option value='American Medical Association - Medical Student Section of COMP-Northwest-Lebanon' >American Medical Association - Medical Student Section of COMP-Northwest-Lebanon<\/option><option value='American Medical Student Association' >American Medical Student Association<\/option><option value='American Medical Women&#039;s Association\/OB-GYN Club' >American Medical Women&#039;s Association\/OB-GYN Club<\/option><option value='American Medical Women&#039;s Association-Lebanon' >American Medical Women&#039;s Association-Lebanon<\/option><option value='American Optometric Student Association' >American Optometric Student Association<\/option><option value='American Pharmacists Association - Academy of Students' >American Pharmacists Association - Academy of Students<\/option><option value='American Student Dental Association' >American Student Dental Association<\/option><option value='Anesthesiology Club' >Anesthesiology Club<\/option><option value='Animal Nutrition Club' >Animal Nutrition Club<\/option><option value='Armenian Student Association' >Armenian Student Association<\/option><option value='Artificial Intelligence in Medicine-Lebanon' >Artificial Intelligence in Medicine-Lebanon<\/option><option value='Asian Pacific American Medical Student Association- Pomona' >Asian Pacific American Medical Student Association- Pomona<\/option><option value='Asian-Pacific American Medical Student Association-Lebanon' >Asian-Pacific American Medical Student Association-Lebanon<\/option><option value='Beta Sigma Kappa Optometric Honor Society' >Beta Sigma Kappa Optometric Honor Society<\/option><option value='Bioethics Interest Group' >Bioethics Interest Group<\/option><option value='California Medical Association' >California Medical Association<\/option><option value='California Society of Health System Pharmacists' >California Society of Health System Pharmacists<\/option><option value='Cardiology Interest Group' >Cardiology Interest Group<\/option><option value='Chinese-American Health Students Association' >Chinese-American Health Students Association<\/option><option value='Christian Fellowship Club-Lebanon' >Christian Fellowship Club-Lebanon<\/option><option value='Club of Psychiatry Enthusiasts' >Club of Psychiatry Enthusiasts<\/option><option value='College of Optometrists in Vision Development' >College of Optometrists in Vision Development<\/option><option value='Contact Lens Club' >Contact Lens Club<\/option><option value='Cultural Awareness Club-Lebanon' >Cultural Awareness Club-Lebanon<\/option><option value='Delta Sigma Delta Dental Fraternity' >Delta Sigma Delta Dental Fraternity<\/option><option value='Dental Student Research Group' >Dental Student Research Group<\/option><option value='Dermatology Interest Group' >Dermatology Interest Group<\/option><option value='Dermatology Interest Group - Lebanon' >Dermatology Interest Group - Lebanon<\/option><option value='Doctor of Nursing Practice Association' >Doctor of Nursing Practice Association<\/option><option value='Emergency Medicine Interest Group-Lebanon' >Emergency Medicine Interest Group-Lebanon<\/option><option value='Emergency Medicine Interest Group-Pomona' >Emergency Medicine Interest Group-Pomona<\/option><option value='Environmental Advocates: Right to Health' >Environmental Advocates: Right to Health<\/option><option value='Fellowship of Christian Optometrists' >Fellowship of Christian Optometrists<\/option><option value='Filipino American Student Association' >Filipino American Student Association<\/option><option value='Forensics Club-Lebanon' >Forensics Club-Lebanon<\/option><option value='Gastroenterology Interest Group' >Gastroenterology Interest Group<\/option><option value='Genetics and Medical Technology Interest Group' >Genetics and Medical Technology Interest Group<\/option><option value='Global Health Club-Lebanon' >Global Health Club-Lebanon<\/option><option value='Global Health Club-Pomona' >Global Health Club-Pomona<\/option><option value='Gold Humanism Honor Society' >Gold Humanism Honor Society<\/option><option value='Gold Humanism Honor Society-Lebanon' >Gold Humanism Honor Society-Lebanon<\/option><option value='Harm Reduction and Addiction Medicine Interest Group' >Harm Reduction and Addiction Medicine Interest Group<\/option><option value='Harm Reduction and Addiction Medicine Interest Group-Lebanon' >Harm Reduction and Addiction Medicine Interest Group-Lebanon<\/option><option value='Harvest Harmony' >Harvest Harmony<\/option><option value='Hispanic Student Dental Association' >Hispanic Student Dental Association<\/option><option value='Humor and Art as Medicine' >Humor and Art as Medicine<\/option><option value='Industry Pharmacists Organization' >Industry Pharmacists Organization<\/option><option value='Inland Empire Outreach' >Inland Empire Outreach<\/option><option value='Integrative Medicine Club' >Integrative Medicine Club<\/option><option value='Internal Medicine Club- Lebanon' >Internal Medicine Club- Lebanon<\/option><option value='Interventional Radiology Interest Group' >Interventional Radiology Interest Group<\/option><option value='Interventional Radiology Interest Group-Lebanon' >Interventional Radiology Interest Group-Lebanon<\/option><option value='Iranian Student Association' >Iranian Student Association<\/option><option value='Jewish Student Association' >Jewish Student Association<\/option><option value='Kappa Psi Pharmaceutical Fraternity' >Kappa Psi Pharmaceutical Fraternity<\/option><option value='Korean Student Association' >Korean Student Association<\/option><option value='Latino Medical Student Association' >Latino Medical Student Association<\/option><option value='Latino Medical Student Association-Lebanon' >Latino Medical Student Association-Lebanon<\/option><option value='Latinx Veterinary Medical Association' >Latinx Veterinary Medical Association<\/option><option value='Latter Day Saints Student Association' >Latter Day Saints Student Association<\/option><option value='LGBTQ Equality Alliance-Pomona' >LGBTQ Equality Alliance-Pomona<\/option><option value='LGBTQ Equality Alliance-Lebanon' >LGBTQ Equality Alliance-Lebanon<\/option><option value='Lifestyle Medicine Interest Group' >Lifestyle Medicine Interest Group<\/option><option value='Lions Club @ WesternU' >Lions Club @ WesternU<\/option><option value='Medical Students for Choice-Lebanon' >Medical Students for Choice-Lebanon<\/option><option value='Middle Eastern Health Professional Association' >Middle Eastern Health Professional Association<\/option><option value='Military Medical Student Association' >Military Medical Student Association<\/option><option value='Military Medical Student Association-Lebanon' >Military Medical Student Association-Lebanon<\/option><option value='Musicians in Medicine' >Musicians in Medicine<\/option><option value='Muslim Student Association' >Muslim Student Association<\/option><option value='Narrative Medicine Club-Lebanon' >Narrative Medicine Club-Lebanon<\/option><option value='National Community Pharmacists Association' >National Community Pharmacists Association<\/option><option value='National Hispanic Pharmacists Association' >National Hispanic Pharmacists Association<\/option><option value='National Optometric Student Association' >National Optometric Student Association<\/option><option value='National Student Nurse Association' >National Student Nurse Association<\/option><option value='OB-GYN Club - Lebanon' >OB-GYN Club - Lebanon<\/option><option value='Oncology Interest Group' >Oncology Interest Group<\/option><option value='Ophthalmology Interest Group' >Ophthalmology Interest Group<\/option><option value='Optometric Extension Program' >Optometric Extension Program<\/option><option value='Optometry Private Practice Club' >Optometry Private Practice Club<\/option><option value='Orthodox Union Jewish Learning on Campus' >Orthodox Union Jewish Learning on Campus<\/option><option value='Osteopathic Physicians &amp; Surgeons of California' >Osteopathic Physicians &amp; Surgeons of California<\/option><option value='Osteopathic Physicians and Surgeons of Oregon' >Osteopathic Physicians and Surgeons of Oregon<\/option><option value='Parasitology Club' >Parasitology Club<\/option><option value='Pathology Interest Group' >Pathology Interest Group<\/option><option value='Pediatric Interest Group' >Pediatric Interest Group<\/option><option value='Phi Delta Epsilon' >Phi Delta Epsilon<\/option><option value='Phi Lambda Sigma - Gamma Nu Chapter' >Phi Lambda Sigma - Gamma Nu Chapter<\/option><option value='Physical Medicine &amp; Rehabilitation Club' >Physical Medicine &amp; Rehabilitation Club<\/option><option value='Physical Medicine and Rehabilitation-Lebanon' >Physical Medicine and Rehabilitation-Lebanon<\/option><option value='Physical Therapy Advocacy Club' >Physical Therapy Advocacy Club<\/option><option value='Physical Therapy Advocacy Club-Lebanon' >Physical Therapy Advocacy Club-Lebanon<\/option><option value='Physician Assistant Student Society' >Physician Assistant Student Society<\/option><option value='Pipeline to Health Careers-Pomona' >Pipeline to Health Careers-Pomona<\/option><option value='Podopediatrics Club' >Podopediatrics Club<\/option><option value='Pomona Community Health Action Team' >Pomona Community Health Action Team<\/option><option value='Pomona Homeless Outreach Project' >Pomona Homeless Outreach Project<\/option><option value='Prison Education Project' >Prison Education Project<\/option><option value='Psychiatry Student Interest Group Network-Lebanon' >Psychiatry Student Interest Group Network-Lebanon<\/option><option value='Public Health Club' >Public Health Club<\/option><option value='Rare Disease Interest Group' >Rare Disease Interest Group<\/option><option value='Recreation Networking Club-Lebanon' >Recreation Networking Club-Lebanon<\/option><option value='Research Club-Lebanon' >Research Club-Lebanon<\/option><option value='Rho Chi Society' >Rho Chi Society<\/option><option value='Rural Health Club-Lebanon' >Rural Health Club-Lebanon<\/option><option value='SC - American Association of Avian Pathologists' >SC - American Association of Avian Pathologists<\/option><option value='SC - American Association of Bovine Practitioners' >SC - American Association of Bovine Practitioners<\/option><option value='SC - American Association of Equine Practitioners' >SC - American Association of Equine Practitioners<\/option><option value='SC - American Association of Feline Practitioners' >SC - American Association of Feline Practitioners<\/option><option value='SC - American College of Veterinary Internal Medicine' >SC - American College of Veterinary Internal Medicine<\/option><option value='SC - American College of Veterinary Pathologists' >SC - American College of Veterinary Pathologists<\/option><option value='SC - American Holistic Veterinary Medicine Association' >SC - American Holistic Veterinary Medicine Association<\/option><option value='SC - American Osteopathic Association of Orthopedics' >SC - American Osteopathic Association of Orthopedics<\/option><option value='SC - American Veterinary Society of Animal Behavior' >SC - American Veterinary Society of Animal Behavior<\/option><option value='SC - Association of Shelter Veterinarians' >SC - Association of Shelter Veterinarians<\/option><option value='SC - Christian Veterinary Mission' >SC - Christian Veterinary Mission<\/option><option value='SC - Humane Society Veterinary Medical Alliance' >SC - Humane Society Veterinary Medical Alliance<\/option><option value='SC - Society for Theriogenology' >SC - Society for Theriogenology<\/option><option value='SC - World Aquatic Veterinary Medical Association' >SC - World Aquatic Veterinary Medical Association<\/option><option value='Sigma Sigma Phi' >Sigma Sigma Phi<\/option><option value='Sigma Sigma Phi-Lebanon' >Sigma Sigma Phi-Lebanon<\/option><option value='Society for Medical &amp; Bioethics-Lebanon' >Society for Medical &amp; Bioethics-Lebanon<\/option><option value='Southern CA Podiatric Medical Students&#039; Association' >Southern CA Podiatric Medical Students&#039; Association<\/option><option value='Specialties Club-Lebanon' >Specialties Club-Lebanon<\/option><option value='Sports Medicine Club-Lebanon' >Sports Medicine Club-Lebanon<\/option><option value='Student American Osteopathic Academy of Sports Medicine' >Student American Osteopathic Academy of Sports Medicine<\/option><option value='Sports Vision Club' >Sports Vision Club<\/option><option value='Student American Academy of Osteopathy-Lebanon' >Student American Academy of Osteopathy-Lebanon<\/option><option value='Student American Academy of Osteopathy-Pomona' >Student American Academy of Osteopathy-Pomona<\/option><option value='Student American Osteopathic Association of Orthopedics-Lebanon' >Student American Osteopathic Association of Orthopedics-Lebanon<\/option><option value='Student American Veterinary Medical Association' >Student American Veterinary Medical Association<\/option><option value='Student Interest Group in Neurology' >Student Interest Group in Neurology<\/option><option value='Student Interest Group in Neurology-Lebanon' >Student Interest Group in Neurology-Lebanon<\/option><option value='Student National Dental Association' >Student National Dental Association<\/option><option value='Student National Medical Association' >Student National Medical Association<\/option><option value='Student Osteopathic Internal Medicine Association' >Student Osteopathic Internal Medicine Association<\/option><option value='Student Osteopathic Medical Association-Lebanon' >Student Osteopathic Medical Association-Lebanon<\/option><option value='Student Osteopathic Medical Association-Pomona' >Student Osteopathic Medical Association-Pomona<\/option><option value='Student Osteopathic Surgical Association-Pomona' >Student Osteopathic Surgical Association-Pomona<\/option><option value='Student Veterinary Emergency Critical Care Society' >Student Veterinary Emergency Critical Care Society<\/option><option value='Student Volunteer Optometry Services to Humanity' >Student Volunteer Optometry Services to Humanity<\/option><option value='Telemedicine Interest Club' >Telemedicine Interest Club<\/option><option value='Ultrasound Club' >Ultrasound Club<\/option><option value='Ultrasound Club-Lebanon' >Ultrasound Club-Lebanon<\/option><option value='Veterinary Business Management Association' >Veterinary Business Management Association<\/option><option value='Veterinary Diagnostic Imaging Club' >Veterinary Diagnostic Imaging Club<\/option><option value='Veterinary Histology Club' >Veterinary Histology Club<\/option><option value='Veterinary Research Club' >Veterinary Research Club<\/option><option value='Veterinary Surgery Club' >Veterinary Surgery Club<\/option><option value='Vietnamese Student Association' >Vietnamese Student Association<\/option><option value='White Coats for Black Lives' >White Coats for Black Lives<\/option><option value='White Coats for Black Lives - Lebanon' >White Coats for Black Lives - Lebanon<\/option><option value='Wilderness Medicine Club' >Wilderness Medicine Club<\/option><option value='Wilderness Medicine Club-Lebanon' >Wilderness Medicine Club-Lebanon<\/option><option value='Zoological, Exotic Companion, and Wildlife Medicine Society' >Zoological, Exotic Companion, and Wildlife Medicine Society<\/option><option value='' ><\/option><\/select><\/div><\/div><div id=\"field_69_18\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><br \/>\n<br \/>\n<br \/>\n<br \/><\/div><div id=\"field_69_11\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full 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_69_11'>What is the club&#039;s proposed name?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_69_11' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_24\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full 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_69_24'>What is the club&#039;s proposed acronym?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_24' id='input_69_24' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_19\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><br \/>\n<br \/>\n<br \/>\n<br \/><\/div><div id=\"field_69_6\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full 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_69_6'>Club&#039;s Current E-mail Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_6' id='input_69_6' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='SELECT ONE' >SELECT ONE<\/option><option value='AGDClub@westernu.edu' >AGDClub@westernu.edu<\/option><option value='AMCPclub@westernu.edu' >AMCPclub@westernu.edu<\/option><option value='AAPPMClub@westernu.edu' >AAPPMClub@westernu.edu<\/option><option value='AAPSMclub@westernu.edu' >AAPSMclub@westernu.edu<\/option><option value='AAMNclub@westernu.edu' >AAMNclub@westernu.edu<\/option><option value='AAPHDClub@westernu.edu' >AAPHDClub@westernu.edu<\/option><option value='AAWDclub@westernu.edu' >AAWDclub@westernu.edu<\/option><option value='AAWPClub@westernu.edu' >AAWPClub@westernu.edu<\/option><option value='ACFASclub@westernu.edu' >ACFASclub@westernu.edu<\/option><option value='ACOFPclub@westernu.edu' >ACOFPclub@westernu.edu<\/option><option value='ACOFPClubLebanon@westernu.edu' >ACOFPClubLebanon@westernu.edu<\/option><option value='ACOPClubLebanon@westernu.edu' >ACOPClubLebanon@westernu.edu<\/option><option value='SOSAclublebanon@westernu.edu' >SOSAclublebanon@westernu.edu<\/option><option value='acpmclub@westernu.edu' >acpmclub@westernu.edu<\/option><option value='ADEAclub@westernu.edu' >ADEAclub@westernu.edu<\/option><option value='AMAclubLebanon@westernu.edu' >AMAclubLebanon@westernu.edu<\/option><option value='AMSAclub@westernu.edu' >AMSAclub@westernu.edu<\/option><option value='AMWA-OBGYNclub@westernu.edu' >AMWA-OBGYNclub@westernu.edu<\/option><option value='AMWAclubLebanon@westernu.edu' >AMWAclubLebanon@westernu.edu<\/option><option value='AOSAclub@westernu.edu' >AOSAclub@westernu.edu<\/option><option value='APhAclub@westernu.edu' >APhAclub@westernu.edu<\/option><option value='ASDAclub@westernu.edu' >ASDAclub@westernu.edu<\/option><option value='ANESclub@westernu.edu' >ANESclub@westernu.edu<\/option><option value='ANCClub@westernu.edu' >ANCClub@westernu.edu<\/option><option value='ASAclub@westernu.edu' >ASAclub@westernu.edu<\/option><option value='AIIMclublebanon@westernu.edu' >AIIMclublebanon@westernu.edu<\/option><option value='APAMSAclub@westernu.edu' >APAMSAclub@westernu.edu<\/option><option value='APAMSAclubLebanon@westernu.edu' >APAMSAclubLebanon@westernu.edu<\/option><option value='BSKclub@westernu.edu' >BSKclub@westernu.edu<\/option><option value='BIGclub@westernu.edu' >BIGclub@westernu.edu<\/option><option value='LACMAclub@westernu.edu' >LACMAclub@westernu.edu<\/option><option value='CSHPclub@westernu.edu' >CSHPclub@westernu.edu<\/option><option value='CIGClub@westernu.edu' >CIGClub@westernu.edu<\/option><option value='CAHSAclub@westernu.edu' >CAHSAclub@westernu.edu<\/option><option value='CFclublebanon@westernu.edu' >CFclublebanon@westernu.edu<\/option><option value='COPEclub@westernu.edu' >COPEclub@westernu.edu<\/option><option value='COVDclub@westernu.edu' >COVDclub@westernu.edu<\/option><option value='CLclub@westernu.edu' >CLclub@westernu.edu<\/option><option value='CACClubLebanon@westernu.edu' >CACClubLebanon@westernu.edu<\/option><option value='DSDclub@westernu.edu' >DSDclub@westernu.edu<\/option><option value='DSRGclub@westernu.edu' >DSRGclub@westernu.edu<\/option><option value='DIGclub@westernu.edu' >DIGclub@westernu.edu<\/option><option value='DIGClubLebanon@westernu.edu' >DIGClubLebanon@westernu.edu<\/option><option value='DNPclub@westernu.edu' >DNPclub@westernu.edu<\/option><option value='EMclublebanon@westernu.edu' >EMclublebanon@westernu.edu<\/option><option value='Emclub@westernu.edu' >Emclub@westernu.edu<\/option><option value='EARTHclub@westernu.edu' >EARTHclub@westernu.edu<\/option><option value='EAclub@westernu.edu' >EAclub@westernu.edu<\/option><option value='FCOclub@westernu.edu' >FCOclub@westernu.edu<\/option><option value='FASAClub@westernu.edu' >FASAClub@westernu.edu<\/option><option value='FCClubLebanon@westernu.edu' >FCClubLebanon@westernu.edu<\/option><option value='GIGclub@westernu.edu' >GIGclub@westernu.edu<\/option><option value='GMTIGclub@westernu.edu' >GMTIGclub@westernu.edu<\/option><option value='GHCclubLebanon@westernu.edu' >GHCclubLebanon@westernu.edu<\/option><option value='GHCclub@westernu.edu' >GHCclub@westernu.edu<\/option><option value='GHHSclub@westernu.edu' >GHHSclub@westernu.edu<\/option><option value='GHHSclubLebanon@westernu.edu' >GHHSclubLebanon@westernu.edu<\/option><option value='HRAMclub@westernu.edu' >HRAMclub@westernu.edu<\/option><option value='HRAMClubLebanon@westernu.edu' >HRAMClubLebanon@westernu.edu<\/option><option value='HHclub@westernu.edu' >HHclub@westernu.edu<\/option><option value='HSDAclub@westernu.edu' >HSDAclub@westernu.edu<\/option><option value='Hamclub@westernu.edu' >Hamclub@westernu.edu<\/option><option value='IPhOClub@westernu.edu' >IPhOClub@westernu.edu<\/option><option value='ieoclub@westernu.edu' >ieoclub@westernu.edu<\/option><option value='imcclub@westernu.edu' >imcclub@westernu.edu<\/option><option value='IMCclubLebanon@westernu.edu' >IMCclubLebanon@westernu.edu<\/option><option value='RTclub@westernu.edu' >RTclub@westernu.edu<\/option><option value='IRIGclubLebanon@westernu.edu' >IRIGclubLebanon@westernu.edu<\/option><option value='ISAclub@westernu.edu' >ISAclub@westernu.edu<\/option><option value='JSAclub@westernu.edu' >JSAclub@westernu.edu<\/option><option value='KPPFclub@westernu.edu' >KPPFclub@westernu.edu<\/option><option value='KSAclub@westernu.edu' >KSAclub@westernu.edu<\/option><option value='LMSAclub@westernu.edu' >LMSAclub@westernu.edu<\/option><option value='LMSAclubLebanon@westernu.edu' >LMSAclubLebanon@westernu.edu<\/option><option value='LVMAClub@westernu.edu' >LVMAClub@westernu.edu<\/option><option value='LDSSAclub@westernu.edu' >LDSSAclub@westernu.edu<\/option><option value='LGBTQClub@WesternU.edu' >LGBTQClub@WesternU.edu<\/option><option value='LMIGclub@westernu.edu' >LMIGclub@westernu.edu<\/option><option value='Lionsclub@westernu.edu' >Lionsclub@westernu.edu<\/option><option value='MSFCclublebanon@westernu.edu' >MSFCclublebanon@westernu.edu<\/option><option value='Mehpaclub@westernu.edu' >Mehpaclub@westernu.edu<\/option><option value='MMSAclub@westernu.edu' >MMSAclub@westernu.edu<\/option><option value='MMSAclubLebanon@westernu.edu' >MMSAclubLebanon@westernu.edu<\/option><option value='MMClub@westernu.edu' >MMClub@westernu.edu<\/option><option value='MSAclub@westernu.edu' >MSAclub@westernu.edu<\/option><option value='NMCClubLebanon@westernu.edu' >NMCClubLebanon@westernu.edu<\/option><option value='NCPAclub@westernu.edu' >NCPAclub@westernu.edu<\/option><option value='NHPAclub@westernu.edu' >NHPAclub@westernu.edu<\/option><option value='NOSAclub@westernu.edu' >NOSAclub@westernu.edu<\/option><option value='NSNAclub@westernu.edu' >NSNAclub@westernu.edu<\/option><option value='OBGYNclubLebanon@westernu.edu' >OBGYNclubLebanon@westernu.edu<\/option><option value='OIGclub@westernu.edu' >OIGclub@westernu.edu<\/option><option value='OpIGclub@westernu.edu' >OpIGclub@westernu.edu<\/option><option value='OEPclub@westernu.edu' >OEPclub@westernu.edu<\/option><option value='OPPBclub@westernu.edu' >OPPBclub@westernu.edu<\/option><option value='OUJLICclub@westernu.edu' >OUJLICclub@westernu.edu<\/option><option value='OPSCclub@westernu.edu' >OPSCclub@westernu.edu<\/option><option value='OPSOClubLebanon@westernu.edu' >OPSOClubLebanon@westernu.edu<\/option><option value='ParasitologyClub@westernu.edu' >ParasitologyClub@westernu.edu<\/option><option value='PIGClub@westernu.edu' >PIGClub@westernu.edu<\/option><option value='pediatricclub@westernu.edu' >pediatricclub@westernu.edu<\/option><option value='PDEclub@westernu.edu' >PDEclub@westernu.edu<\/option><option value='PLSclub@westernu.edu' >PLSclub@westernu.edu<\/option><option value='PMARCclub@westernu.edu' >PMARCclub@westernu.edu<\/option><option value='PMARCClubLebanon@westernu.edu' >PMARCClubLebanon@westernu.edu<\/option><option value='PTACclub@westernu.edu' >PTACclub@westernu.edu<\/option><option value='PTACclubLebanon@westernu.edu' >PTACclubLebanon@westernu.edu<\/option><option value='PASSclub@westernu.edu' >PASSclub@westernu.edu<\/option><option value='PHC@westernu.edu' >PHC@westernu.edu<\/option><option value='Podopedclub@westernu.edu' >Podopedclub@westernu.edu<\/option><option value='PCHAT@westernu.edu' >PCHAT@westernu.edu<\/option><option value='PHOP@westernu.edu' >PHOP@westernu.edu<\/option><option value='PEPclub@westernu.edu' >PEPclub@westernu.edu<\/option><option value='PsychSIGNClubLebanon@westernu.edu' >PsychSIGNClubLebanon@westernu.edu<\/option><option value='PublicHealthClub@westernu.edu' >PublicHealthClub@westernu.edu<\/option><option value='RDIGclub@westernu.edu' >RDIGclub@westernu.edu<\/option><option value='Recreationclublebanon@westernu.edu' >Recreationclublebanon@westernu.edu<\/option><option value='ResearchclubLebanon@westernu.edu' >ResearchclubLebanon@westernu.edu<\/option><option value='RhoChiclub@westernu.edu' >RhoChiclub@westernu.edu<\/option><option value='RHclubLebanon@westernu.edu' >RHclubLebanon@westernu.edu<\/option><option value='SC-AAAPclub@westernu.edu' >SC-AAAPclub@westernu.edu<\/option><option value='SCAABPclub@westernu.edu' >SCAABPclub@westernu.edu<\/option><option value='SCAAEPclub@westernu.edu' >SCAAEPclub@westernu.edu<\/option><option value='SCAAFPclub@westernu.edu' >SCAAFPclub@westernu.edu<\/option><option value='SCACVIMclub@westernu.edu' >SCACVIMclub@westernu.edu<\/option><option value='SCACVPclub@westernu.edu' >SCACVPclub@westernu.edu<\/option><option value='HolisticVetclub@westernu.edu' >HolisticVetclub@westernu.edu<\/option><option value='SAOAOclub@westernu.edu' >SAOAOclub@westernu.edu<\/option><option value='SCAVSABclub@westernu.edu' >SCAVSABclub@westernu.edu<\/option><option value='SCASVclub@westernu.edu' >SCASVclub@westernu.edu<\/option><option value='SCCVMclub@westernu.edu' >SCCVMclub@westernu.edu<\/option><option value='SCHSVMAclub@westernu.edu' >SCHSVMAclub@westernu.edu<\/option><option value='Therioclub@westernu.edu' >Therioclub@westernu.edu<\/option><option value='SCAquaticVMAclub@westernu.edu' >SCAquaticVMAclub@westernu.edu<\/option><option value='SSPclub@westernu.edu' >SSPclub@westernu.edu<\/option><option value='SSPclubLebanon@westernu.edu' >SSPclubLebanon@westernu.edu<\/option><option value='SMBclubLebanon@westernu.edu' >SMBclubLebanon@westernu.edu<\/option><option value='SCPMSA@westernu.edu' >SCPMSA@westernu.edu<\/option><option value='SpecialtiesclubLebanon@westernu.edu' >SpecialtiesclubLebanon@westernu.edu<\/option><option value='SMclubLebanon@westernu.edu' >SMclubLebanon@westernu.edu<\/option><option value='SMclub@westernu.edu' >SMclub@westernu.edu<\/option><option value='SVclub@westernu.edu' >SVclub@westernu.edu<\/option><option value='SAAOclubLebanon@westernu.edu' >SAAOclubLebanon@westernu.edu<\/option><option value='SAAOclub@westernu.edu' >SAAOclub@westernu.edu<\/option><option value='SAOAOclubLebanon@westernu.edu' >SAOAOclubLebanon@westernu.edu<\/option><option value='SAVMA@westernu.edu' >SAVMA@westernu.edu<\/option><option value='SIGNclub@westernu.edu' >SIGNclub@westernu.edu<\/option><option value='SIGNclubLebanon@westernu.edu' >SIGNclubLebanon@westernu.edu<\/option><option value='SNDAclub@westernu.edu' >SNDAclub@westernu.edu<\/option><option value='SNMAclub@westernu.edu' >SNMAclub@westernu.edu<\/option><option value='SOIMAclub@westernu.edu' >SOIMAclub@westernu.edu<\/option><option value='SOMAclublebanon@westernu.edu' >SOMAclublebanon@westernu.edu<\/option><option value='SOMAclub@westernu.edu' >SOMAclub@westernu.edu<\/option><option value='SOSAclub@westernu.edu' >SOSAclub@westernu.edu<\/option><option value='SVECCSclub@westernu.edu' >SVECCSclub@westernu.edu<\/option><option value='sVOSHclub@westernu.edu' >sVOSHclub@westernu.edu<\/option><option value='TICclub@westernu.edu' >TICclub@westernu.edu<\/option><option value='UltrasoundClub@westernu.edu' >UltrasoundClub@westernu.edu<\/option><option value='UltrasoundClubLebanon@westernu.edu' >UltrasoundClubLebanon@westernu.edu<\/option><option value='VBMAclub@westernu.edu' >VBMAclub@westernu.edu<\/option><option value='VDICClub@westernu.edu' >VDICClub@westernu.edu<\/option><option value='VHClub@westernu.edu' >VHClub@westernu.edu<\/option><option value='DVMResclub@westernu.edu' >DVMResclub@westernu.edu<\/option><option value='VetSurgeryclub@westernu.edu' >VetSurgeryclub@westernu.edu<\/option><option value='WVSAclub@westernu.edu' >WVSAclub@westernu.edu<\/option><option value='WC4BLClub@westernu.edu' >WC4BLClub@westernu.edu<\/option><option value='WC4BLClubLebanon@westernu.edu' >WC4BLClubLebanon@westernu.edu<\/option><option value='WMclub@westernu.edu' >WMclub@westernu.edu<\/option><option value='WMCClubLebanon@westernu.edu' >WMCClubLebanon@westernu.edu<\/option><option value='ZEWclub@westernu.edu' >ZEWclub@westernu.edu<\/option><option value='' ><\/option><\/select><\/div><\/div><div id=\"field_69_15\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><br \/>\n<br \/>\n<br \/>\n<br \/><\/div><fieldset id=\"field_69_12\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full 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' >Regarding the club&#039;s e-mail address. What is your preference?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_12'>\n\t\t\t<div class='gchoice gchoice_69_12_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='No Change'  id='choice_69_12_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_12_0' id='label_69_12_0' class='gform-field-label gform-field-label--type-inline'>No Change<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_12_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Keep the e-mail address but change the display name'  id='choice_69_12_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_12_1' id='label_69_12_1' class='gform-field-label gform-field-label--type-inline'>Keep the e-mail address but change the display name<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_12_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Change the e-mail address and the display name'  id='choice_69_12_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_12_2' id='label_69_12_2' class='gform-field-label gform-field-label--type-inline'>Change the e-mail address and the display name<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_69_21\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><br \/>\n<br \/>\n<br \/>\n<br \/><\/div><div id=\"field_69_9\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_9'>What is the proposed e-mail address?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_69_9' type='text' value='' class='large'  aria-describedby=\"gfield_description_69_9\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_69_9'>The club's e-mail address is typically acronym+club@westernu.edu. <\/div><\/div><div id=\"field_69_20\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><br \/>\n<br \/>\n<br \/>\n<br \/><\/div><div id=\"field_69_10\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full 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_69_10'>Provide a brief reason for the name change:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_10' id='input_69_10' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_69_22\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><br \/>\n<br \/>\n<br \/>\n<br \/><\/div><div id=\"field_69_14\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Upon submit, University Student Affairs (studentaffairs@westernu.edu) and the Executive SGA (sga@westernu.edu) will receive an e-mail with your request. <br \/>\nThe Executive SGA will reach out to you with the Senate meeting schedule, and you'll present your request to the Student Senate. Please note the Student Senate Meets the 1st and 3rd Tuesday from October to May (with some exceptions). <br \/>\nIf approved, University Student Affairs will update our records and will reach out if there are any concerns or questions. <\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_69' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Submit'  \/> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_69' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_69' id='gform_theme_69' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_69' id='gform_style_settings_69' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_69' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='69' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='+Enem4j+sN3X1PEx6J0RKoHILF8qMUx2qyommoQslKG0hUREwNo8CxyyJ4RALAWwTdwnd+VA8rd8EFycov2P3kRyH8yZfbkV+J8ttH\/Tbj3TJUY=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_69' 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