{"id":7344,"date":"2024-01-02T10:26:28","date_gmt":"2024-01-02T15:26:28","guid":{"rendered":"https:\/\/henryjaustin.org\/sti-hiv-services-copy\/"},"modified":"2026-05-13T15:26:38","modified_gmt":"2026-05-13T19:26:38","slug":"event-requests","status":"publish","type":"page","link":"https:\/\/henryjaustin.org\/es\/event-requests\/","title":{"rendered":"Solicitudes de eventos"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><div class=\"webique_vc_row_wrap webique_general_colors\"><div class=\"vc_row wpb_row vc_row-fluid\"><div class=\"wpb_column vc_column_container vc_col-sm-12\"><div class=\"vc_column-inner vc_custom_1704295482637\"><div class=\"wpb_wrapper\">\n\t<div class=\"wpb_text_column wpb_content_element\" >\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t<h3><span class=\"TextRun SCXW174765765 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW174765765 BCX0\">Request the Mobile Health Unit or Invite HJAHC to Your Event<\/span><\/span><\/h3>\n\n\t\t<\/div>\n\t<\/div>\n<\/div><\/div><\/div><\/div><\/div><div class=\"webique_vc_row_wrap webique_general_colors\"><div class=\"vc_row wpb_row vc_row-fluid\"><div class=\"wpb_column vc_column_container vc_col-sm-6\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\">\n\t<div class=\"wpb_text_column wpb_content_element wpb_animate_when_almost_visible wpb_slideInLeft slideInLeft\" >\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t<p><span class=\"TextRun SCXW30549092 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW30549092 BCX0\">HJAHC is proud to support local organizations, schools, and community partners through our participation in health fairs, resource events, and public engagement opportunities. Whether <\/span><span class=\"NormalTextRun SCXW30549092 BCX0\">you\u2019re<\/span><span class=\"NormalTextRun SCXW30549092 BCX0\"> interested in hosting the Mobile Health Unit or inviting our team to share information and resources, we welcome your request.<\/span><\/span><span class=\"EOP SCXW30549092 BCX0\" data-ccp-props=\"{&quot;335559685&quot;:0}\">\u00a0<\/span><\/p>\n\n\t\t<\/div>\n\t<\/div>\n<\/div><\/div><\/div><div class=\"wpb_column vc_column_container vc_col-sm-6\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\">\n\t<div  class=\"wpb_single_image wpb_content_element vc_align_left wpb_content_element\">\n\t\t\n\t\t<figure class=\"wpb_wrapper vc_figure\">\n\t\t\t<div class=\"vc_single_image-wrapper vc_box_rounded  vc_box_border_grey\"><img decoding=\"async\" width=\"2048\" height=\"1811\" data-src=\"https:\/\/henryjaustin.org\/wp-content\/uploads\/2024\/01\/IMG_0172-scaled.jpg\" class=\"vc_single_image-img attachment-full lazyload\" alt=\"\" title=\"IMG_0172\" data-srcset=\"https:\/\/henryjaustin.org\/wp-content\/uploads\/2024\/01\/IMG_0172-scaled.jpg 2048w, https:\/\/henryjaustin.org\/wp-content\/uploads\/2024\/01\/IMG_0172-300x265.jpg 300w, https:\/\/henryjaustin.org\/wp-content\/uploads\/2024\/01\/IMG_0172-1024x905.jpg 1024w, https:\/\/henryjaustin.org\/wp-content\/uploads\/2024\/01\/IMG_0172-768x679.jpg 768w, https:\/\/henryjaustin.org\/wp-content\/uploads\/2024\/01\/IMG_0172-1536x1358.jpg 1536w, https:\/\/henryjaustin.org\/wp-content\/uploads\/2024\/01\/IMG_0172-14x12.jpg 14w, https:\/\/henryjaustin.org\/wp-content\/uploads\/2024\/01\/IMG_0172-600x530.jpg 600w\" data-sizes=\"(max-width: 2048px) 100vw, 2048px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 2048px; --smush-placeholder-aspect-ratio: 2048\/1811;\" \/><\/div>\n\t\t<\/figure>\n\t<\/div>\n<\/div><\/div><\/div><\/div><\/div><div class=\"webique_vc_row_wrap webique_general_colors\"><div class=\"vc_row wpb_row vc_row-fluid\"><div class=\"wpb_column vc_column_container vc_col-sm-12\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\"><div class=\"vc_empty_space\"   style=\"height: 32px\"><span class=\"vc_empty_space_inner\"><\/span><\/div><!-- start Line Text Divider -->\n\t\t\t<style type=\"text\/css\">\/* addon: Line Text Divider *\/\n\n#uc_blox_line_text_divider_vc14554 div.blox_hr\n{\n  display:inline-block;\n  width:100%;\n  max-width:1200px;\n  background-color: #ec8c32;\n  height:1px;\n}\n#uc_blox_line_text_divider_vc14554 div.blox_hr_txt\n{\n  display: inline-block;\n  position: relative;\n  margin: 0;\n  padding: 5px 10px;\n  border: 1px solid #ec8c32;\n  transform: translateX(-50%);\n  transform: translateY(-50%);\n  color: #ec8c32;\n  text-align: center;\n  background-color: #fff;\n}\n\n<\/style>\n\n\t\t\t<div id=\"uc_blox_line_text_divider_vc14554\" style=\"text-align:center;\">\n  <div class=\"blox_hr\"><div class=\"blox_hr_txt\">&<\/div><\/div>\n<\/div>\n\t\t\t<!-- end Line Text Divider --><div class=\"vc_empty_space\"   style=\"height: 32px\"><span class=\"vc_empty_space_inner\"><\/span><\/div><div class=\"vc_empty_space\"   style=\"height: 32px\"><span class=\"vc_empty_space_inner\"><\/span><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"webique_vc_row_wrap webique_general_colors\"><div class=\"vc_row wpb_row vc_row-fluid\"><div class=\"wpb_column vc_column_container vc_col-sm-6\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\">\n\t<div  class=\"wpb_single_image wpb_content_element vc_align_right wpb_content_element\">\n\t\t\n\t\t<figure class=\"wpb_wrapper vc_figure\">\n\t\t\t<div class=\"vc_single_image-wrapper vc_box_rounded  vc_box_border_grey\"><img decoding=\"async\" width=\"830\" height=\"682\" data-src=\"https:\/\/henryjaustin.org\/wp-content\/uploads\/2024\/01\/Screenshot-2024-01-02-at-10.58.42-AM-1024x841.png\" class=\"vc_single_image-img attachment-large lazyload\" alt=\"\" title=\"Screenshot 2024-01-02 at 10.58.42 AM\" data-srcset=\"https:\/\/henryjaustin.org\/wp-content\/uploads\/2024\/01\/Screenshot-2024-01-02-at-10.58.42-AM-1024x841.png 1024w, https:\/\/henryjaustin.org\/wp-content\/uploads\/2024\/01\/Screenshot-2024-01-02-at-10.58.42-AM-300x246.png 300w, https:\/\/henryjaustin.org\/wp-content\/uploads\/2024\/01\/Screenshot-2024-01-02-at-10.58.42-AM-768x631.png 768w, https:\/\/henryjaustin.org\/wp-content\/uploads\/2024\/01\/Screenshot-2024-01-02-at-10.58.42-AM-15x12.png 15w, https:\/\/henryjaustin.org\/wp-content\/uploads\/2024\/01\/Screenshot-2024-01-02-at-10.58.42-AM-600x493.png 600w, https:\/\/henryjaustin.org\/wp-content\/uploads\/2024\/01\/Screenshot-2024-01-02-at-10.58.42-AM.png 1276w\" data-sizes=\"(max-width: 830px) 100vw, 830px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 830px; --smush-placeholder-aspect-ratio: 830\/682;\" \/><\/div>\n\t\t<\/figure>\n\t<\/div>\n<\/div><\/div><\/div><div class=\"wpb_column vc_column_container vc_col-sm-6\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\">\n\t<div class=\"wpb_text_column wpb_content_element\" >\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t<h3><span class=\"TextRun SCXW36521799 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW36521799 BCX0\">Mobile Health Unit (MHU)<\/span><\/span><span class=\"EOP SCXW36521799 BCX0\" data-ccp-props=\"{&quot;335559685&quot;:0}\">\u00a0<\/span><\/h3>\n\n\t\t<\/div>\n\t<\/div>\n\n\t<div class=\"wpb_text_column wpb_content_element wpb_animate_when_almost_visible wpb_slideInRight slideInRight\" >\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t<p><span data-contrast=\"auto\">Henry J. Austin Health Center (HJAHC) brings healthcare directly to the community through our Mobile Health Unit (MHU). The MHU provides essential services such as primary care, behavioral health, dental screenings, COVID-19 vaccinations, preventive screenings, and health insurance enrollment support.<\/span><span data-ccp-props=\"{&quot;335559685&quot;:0}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">In addition to regularly scheduled community stops, the MHU also participates in school-based outreach and local events throughout the Trenton area, furthering our mission to deliver equitable, accessible care.<\/span><span data-ccp-props=\"{&quot;335559685&quot;:0}\">\u00a0<\/span><\/p>\n\n\t\t<\/div>\n\t<\/div>\n<\/div><\/div><\/div><\/div><\/div><div class=\"webique_vc_row_wrap webique_general_colors\"><div class=\"vc_row wpb_row vc_row-fluid\"><div class=\"wpb_column vc_column_container vc_col-sm-12\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\"><div class=\"vc_empty_space\"   style=\"height: 32px\"><span class=\"vc_empty_space_inner\"><\/span><\/div><!-- start Line Text Divider -->\n\t\t\t<style type=\"text\/css\">\/* addon: Line Text Divider *\/\n\n#uc_blox_line_text_divider_vc20421 div.blox_hr\n{\n  display:inline-block;\n  width:100%;\n  max-width:1200px;\n  background-color: #ec8c32;\n  height:1px;\n}\n#uc_blox_line_text_divider_vc20421 div.blox_hr_txt\n{\n  display: inline-block;\n  position: relative;\n  margin: 0;\n  padding: 5px 10px;\n  border: 1px solid #ec8c32;\n  transform: translateX(-50%);\n  transform: translateY(-50%);\n  color: #ec8c32;\n  text-align: center;\n  background-color: #fff;\n}\n\n<\/style>\n\n\t\t\t<div id=\"uc_blox_line_text_divider_vc20421\" style=\"text-align:center;\">\n  <div class=\"blox_hr\"><div class=\"blox_hr_txt\">&<\/div><\/div>\n<\/div>\n\t\t\t<!-- end Line Text Divider --><div class=\"vc_empty_space\"   style=\"height: 32px\"><span class=\"vc_empty_space_inner\"><\/span><\/div><div class=\"vc_empty_space\"   style=\"height: 32px\"><span class=\"vc_empty_space_inner\"><\/span><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"webique_vc_row_wrap webique_general_colors\"><div class=\"vc_row wpb_row vc_row-fluid\"><div class=\"wpb_column vc_column_container vc_col-sm-12\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\">\n\t<div class=\"wpb_text_column wpb_content_element\" >\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t<p><b><span data-contrast=\"auto\">Event Request Form\u00a0<\/span><\/b><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;201341983&quot;:0,&quot;335559738&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span class=\"TextRun SCXW7100016 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW7100016 BCX0\">Please complete the Event Request Form below and a member of our team will follow up. While we do our best to accommodate all requests, participation is based on scheduling availability and alignment with our mission.<\/span><\/span><span class=\"EOP SCXW7100016 BCX0\" data-ccp-props=\"{&quot;335559685&quot;:0}\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"auto\">Submission Guidelines:<\/span><\/b><span data-ccp-props=\"{&quot;134233117&quot;:true,&quot;134233118&quot;:true,&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p>Please submit requests at least 30 days in advance to allow enough time for planning and coordination.<\/p>\n<p>All MHU event requests require at least 45 days\u2019 notice.<\/p>\n\n\t\t<\/div>\n\t<\/div>\n<\/div><\/div><\/div><\/div><\/div><div class=\"webique_vc_row_wrap webique_general_colors\"><div class=\"vc_row wpb_row vc_row-fluid\"><div class=\"wpb_column vc_column_container vc_col-sm-12\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\"><script type=\"text\/javascript\">\n\/* 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         <div class='gform-body gform_body'><div id='gform_fields_37' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_37_1\" class=\"gfield gfield--type-text gfield--input-type-text 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_37_1'>Name of Event<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_1' id='input_37_1' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_37_7\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon 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_37_7'>Today&#039;s Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_7' id='input_37_7' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_37_7_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_37_7_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_37_7' class='gform_hidden' value='https:\/\/henryjaustin.org\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_37_4\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon 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_37_4'>Proposed Date of Event<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_4' id='input_37_4' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_37_4_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_37_4_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_37_4' class='gform_hidden' value='https:\/\/henryjaustin.org\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><fieldset id=\"field_37_28\" class=\"gfield gfield--type-time gfield--input-type-time 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 gfield_label_before_complex' >Event Set-Up Time<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class=\"ginput_container ginput_complex gform-grid-row\">\n                        <div class='gfield_time_hour ginput_container ginput_container_time gform-grid-col' id='input_37_28'>\n                            <input type='number' name='input_28[]' id='input_37_28_1' value=''  min='0' max='12' step='1'  placeholder='HH' aria-required='true'   \/> \n                            <label class='gform-field-label gform-field-label--type-sub hour_label screen-reader-text' for='input_37_28_1'>Hours<\/label>\n                        <\/div>\n                        <div class=\"below hour_minute_colon gform-grid-col\">:<\/div>\n                        <div class='gfield_time_minute ginput_container ginput_container_time gform-grid-col'>\n                            <input type='number' name='input_28[]' id='input_37_28_2' value=''  min='0' max='59' step='1'  placeholder='MM' aria-required='true'  \/>\n                            <label class='gform-field-label gform-field-label--type-sub minute_label screen-reader-text' for='input_37_28_2'>Minutes<\/label>\n                        <\/div>\n                        <div class='gfield_time_ampm ginput_container ginput_container_time below gform-grid-col' >\n                                \n                                <select name='input_28[]' id='input_37_28_3'  >\n                                    <option value='am' >AM<\/option>\n                                    <option value='pm' >PM<\/option>\n                                <\/select> \n                                <label class='gform-field-label gform-field-label--type-sub am_pm_label screen-reader-text' for='input_37_28_3'>AM\/PM<\/label>                                \n                           <\/div>\n                    <\/div><\/fieldset><fieldset id=\"field_37_21\" class=\"gfield gfield--type-time gfield--input-type-time 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 gfield_label_before_complex' >Time of Event<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class=\"ginput_container ginput_complex gform-grid-row\">\n                        <div class='gfield_time_hour ginput_container ginput_container_time gform-grid-col' id='input_37_21'>\n                            <input type='number' name='input_21[]' id='input_37_21_1' value=''  min='0' max='12' step='1'  placeholder='HH' aria-required='true'   \/> \n                            <label class='gform-field-label gform-field-label--type-sub hour_label screen-reader-text' for='input_37_21_1'>Hours<\/label>\n                        <\/div>\n                        <div class=\"below hour_minute_colon gform-grid-col\">:<\/div>\n                        <div class='gfield_time_minute ginput_container ginput_container_time gform-grid-col'>\n                            <input type='number' name='input_21[]' id='input_37_21_2' value=''  min='0' max='59' step='1'  placeholder='MM' aria-required='true'  \/>\n                            <label class='gform-field-label gform-field-label--type-sub minute_label screen-reader-text' for='input_37_21_2'>Minutes<\/label>\n                        <\/div>\n                        <div class='gfield_time_ampm ginput_container ginput_container_time below gform-grid-col' >\n                                \n                                <select name='input_21[]' id='input_37_21_3'  >\n                                    <option value='am' >AM<\/option>\n                                    <option value='pm' >PM<\/option>\n                                <\/select> \n                                <label class='gform-field-label gform-field-label--type-sub am_pm_label screen-reader-text' for='input_37_21_3'>AM\/PM<\/label>                                \n                           <\/div>\n                    <\/div><\/fieldset><fieldset id=\"field_37_27\" class=\"gfield gfield--type-time gfield--input-type-time 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 gfield_label_before_complex' >End Time of Event<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class=\"ginput_container ginput_complex gform-grid-row\">\n                        <div class='gfield_time_hour ginput_container ginput_container_time gform-grid-col' id='input_37_27'>\n                            <input type='number' name='input_27[]' id='input_37_27_1' value=''  min='0' max='12' step='1'  placeholder='HH' aria-required='true'   \/> \n                            <label class='gform-field-label gform-field-label--type-sub hour_label screen-reader-text' for='input_37_27_1'>Hours<\/label>\n                        <\/div>\n                        <div class=\"below hour_minute_colon gform-grid-col\">:<\/div>\n                        <div class='gfield_time_minute ginput_container ginput_container_time gform-grid-col'>\n                            <input type='number' name='input_27[]' id='input_37_27_2' value=''  min='0' max='59' step='1'  placeholder='MM' aria-required='true'  \/>\n                            <label class='gform-field-label gform-field-label--type-sub minute_label screen-reader-text' for='input_37_27_2'>Minutes<\/label>\n                        <\/div>\n                        <div class='gfield_time_ampm ginput_container ginput_container_time below gform-grid-col' >\n                                \n                                <select name='input_27[]' id='input_37_27_3'  >\n                                    <option value='am' >AM<\/option>\n                                    <option value='pm' >PM<\/option>\n                                <\/select> \n                                <label class='gform-field-label gform-field-label--type-sub am_pm_label screen-reader-text' for='input_37_27_3'>AM\/PM<\/label>                                \n                           <\/div>\n                    <\/div><\/fieldset><fieldset id=\"field_37_31\" 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' >Is the Event Indoors or Outdoors?<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_37_31'>\n\t\t\t<div class='gchoice gchoice_37_31_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='Indoors'  id='choice_37_31_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_37_31_0' id='label_37_31_0' class='gform-field-label gform-field-label--type-inline'>Indoors<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_37_31_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='Outdoors'  id='choice_37_31_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_37_31_1' id='label_37_31_1' class='gform-field-label gform-field-label--type-inline'>Outdoors<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_37_32\" 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_37_32'>Will Tables and Chairs Be Provided?<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_32' id='input_37_32' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_37_6\" class=\"gfield gfield--type-number gfield--input-type-number 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_37_6'>Approx. Number of People<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_6' id='input_37_6' type='number' step='any'   value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><fieldset id=\"field_37_8\" class=\"gfield gfield--type-address gfield--input-type-address 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 gfield_label_before_complex' >Address of Event<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_37_8' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_37_8_1_container' >\n                                        <input type='text' name='input_8.1' id='input_37_8_1' value=''    aria-required='true'    \/>\n                                        <label for='input_37_8_1' id='input_37_8_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_37_8_2_container' >\n                                        <input type='text' name='input_8.2' id='input_37_8_2' value=''     aria-required='false'   \/>\n                                        <label for='input_37_8_2' id='input_37_8_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_37_8_3_container' >\n                                    <input type='text' name='input_8.3' id='input_37_8_3' value=''    aria-required='true'    \/>\n                                    <label for='input_37_8_3' id='input_37_8_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_37_8_4_container' >\n                                        <select name='input_8.4' id='input_37_8_4'     aria-required='true'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' selected='selected'>New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_37_8_4' id='input_37_8_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_37_8_5_container' >\n                                    <input type='text' name='input_8.5' id='input_37_8_5' value=''    aria-required='true'    \/>\n                                    <label for='input_37_8_5' id='input_37_8_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_8.6' id='input_37_8_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_37_3\" 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_37_3'>Name of your Organization<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_3' id='input_37_3' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_37_9\" class=\"gfield gfield--type-name gfield--input-type-name 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 gfield_label_before_complex' >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_37_9'>\n                            \n                            <span id='input_37_9_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_9.3' id='input_37_9_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_37_9_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_37_9_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_9.6' id='input_37_9_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_37_9_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_37_10\" class=\"gfield gfield--type-phone gfield--input-type-phone 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_37_10'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_10' id='input_37_10' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_37_11\" class=\"gfield gfield--type-email gfield--input-type-email 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_37_11'>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_11' id='input_37_11' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_37_25\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full 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' >Type of Request:<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_37_25'><div class='gchoice gchoice_37_25_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_25.1' type='checkbox'  value='Mobile Health Unit'  id='choice_37_25_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_37_25_1' id='label_37_25_1' class='gform-field-label gform-field-label--type-inline'>Mobile Health Unit<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_37_25_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_25.2' type='checkbox'  value='General Community Engagement\/Event Participation'  id='choice_37_25_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_37_25_2' id='label_37_25_2' class='gform-field-label gform-field-label--type-inline'>General Community Engagement\/Event Participation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_37_25_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_25.3' type='checkbox'  value='Other (please specify)'  id='choice_37_25_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_37_25_3' id='label_37_25_3' class='gform-field-label gform-field-label--type-inline'>Other (please specify)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_37_23\" class=\"gfield gfield--type-textarea gfield--input-type-textarea 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_37_23'>Type of Request: Other (please specify)<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_23' id='input_37_23' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_37_26\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_37_26'>Additional Details or Questions<\/label><div class='gfield_description' id='gfield_description_37_26'>Please include a brief description of the event, including its purpose, target audience, and any additional support or services you\u2019re requesting from HJAHC. <\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_26' id='input_37_26' class='textarea large'  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would like to receive emails from Henry J. Austin Health Center. (You can unsubscribe anytime)<\/label><\/span><\/p><\/div><!--.ctct-optin-hide --><p class=\"ctct-form-field ctct-form-field-submit\"><input aria-required=\"false\"  type=\"submit\" id=\"ctct-submitted_0_925923244\" name=\"ctct-submitted\"  value=\"Sign up\" class=\"ctct-submit ctct-label-top ctct-submitted\"     \/><\/p><div class=\"ctct_usage\" style=\"border: 0 none; clip: rect( 0, 0, 0, 0 ); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px;\"><label for=\"ctct_usage_field\">Constant Contact Use. Please leave this field blank.<\/label><input type=\"text\" value=\"\" id=\"ctct_usage_field\" name=\"ctct_usage_field\" class=\"ctct_usage_field\" tabindex=\"-1\" \/><\/div><input type=\"hidden\" name=\"ctct-id\" value=\"5798\" \/><input type=\"hidden\" name=\"ctct-verify\" value=\"txSgrhKaHIwDxpPCdWjw7JKHY\" \/><input type=\"hidden\" name=\"ctct-instance\" value=\"0\" \/><input type=\"hidden\" name=\"ctct_time\" value=\"1779366698\" \/><\/form><script type=\"text\/javascript\">var ajaxurl = \"https:\/\/henryjaustin.org\/wp-admin\/admin-ajax.php\";<\/script><\/div>\n\n\t\t<\/div>\n\t<\/div>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"vc_row-full-width vc_clearfix\"><\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"Solicite la Unidad M\u00f3vil de Salud o Invite a HJAHC a su Evento HJAHC se enorgullece de apoyar a las organizaciones locales, escuelas y socios de la comunidad a trav\u00e9s de nuestra participaci\u00f3n en ferias de salud, eventos de recursos y oportunidades de participaci\u00f3n p\u00fablica. Ya sea que est\u00e9 interesado en...","protected":false},"author":18,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"class_list":["post-7344","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Event Requests - Henry J. 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