{"id":612,"date":"2021-04-28T15:58:31","date_gmt":"2021-04-28T15:58:31","guid":{"rendered":"https:\/\/www.kacch.org\/?page_id=612"},"modified":"2021-05-02T05:23:39","modified_gmt":"2021-05-02T05:23:39","slug":"referee-recommendation-form","status":"publish","type":"page","link":"https:\/\/www.kacch.org\/referee-recommendation-form\/","title":{"rendered":"Referee Recommendation Form"},"content":{"rendered":"\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f611-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"611\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/mybrand-api\/wp\/v2\/pages\/612#wpcf7-f611-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"611\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f611-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<div class=\"cu-common-form referee-block\">\n\t<div class=\"row\">\n\t\t<div class=\"col-md-6 col-sm-12\">\n\t\t\t<div class=\"form-group\">\n\t\t\t\t<p><label><span class=\"fr-br\">\u0627\u0644\u062a\u0627\u0631\u064a\u062e <\/span> Date<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"Date\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control walcf7-datepicker\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"Date\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-md-6 col-sm-12\">\n\t\t\t<div class=\"form-group\">\n\t\t\t\t<p><label><span class=\"fr-br\">\u0627\u0644\u0627\u0633\u0645<\/span> Full Name<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"full_name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"full_name\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-md-6 col-sm-12\">\n\t\t\t<div class=\"form-group\">\n\t\t\t\t<p><label><span class=\"fr-br\">\u0627\u0644\u0647\u0627\u062a\u0641 <\/span> Mobile Phone Number<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"mobile_phonenumber\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"mobile_phonenumber\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-md-6 col-sm-12\">\n\t\t\t<div class=\"form-group\">\n\t\t\t\t<p><label><span class=\"fr-br\">\u0627\u0644\u0628\u0631\u064a\u062f \u0627\u0644\u0627\u0644\u0643\u062a\u0631\u0648\u0646\u064a <\/span> E-mail<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email form-control\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-md-12 col-sm-12\">\n\t\t\t<div class=\"form-group\">\n\t\t\t\t<p><label><span class=\"fr-br\">\u0627\u0633\u0645 \u0627\u0644\u0645\u062a\u0637\u0648\u0639<\/span> First and Last Name of Applicant<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first_andlastnameofapplicant\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first_andlastnameofapplicant\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-md-12 col-sm-12\">\n\t\t\t<div class=\"form-group\">\n\t\t\t\t<p><label><span class=\"fr-br\">\u0645\u0646\u0630 \u0645\u062a\u0649 \u0648\u0623\u0646\u062a \u062a\u0639\u0631\u0641 \u0645\u0642\u062f\u0645 \u0627\u0644\u0637\u0644\u0628\u061f<\/span> How long have you known the applicant?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"how_longhaveyouknowntheapplicant\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" name=\"how_longhaveyouknowntheapplicant\"><\/textarea><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-md-12 col-sm-12\">\n\t\t\t<div class=\"form-group\">\n\t\t\t\t<p><label><span class=\"fr-br\">\u0645\u0627\u0647\u064a \u0637\u0628\u064a\u0639\u0629 \u0639\u0644\u0627\u0642\u062a\u0643 \u0628\u0627\u0644\u0645\u062a\u0637\u0648\u0639\u061f <\/span> In what capacity have you known the applicant?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"in_whatcapacityhaveyouknowntheapplicant\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" name=\"in_whatcapacityhaveyouknowntheapplicant\"><\/textarea><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-md-12 col-sm-12\">\n\t\t\t<div class=\"form-group\">\n\t\t\t\t<p><label><span class=\"fr-br\">\u0643\u064a\u0641 \u062a\u0635\u0641 \u0645\u0642\u062f\u0645 \u0627\u0644\u0637\u0644\u0628\u061f \u064a\u064f\u0631\u062c\u0649 \u0630\u0643\u0631 \u0623\u064a \u0646\u0642\u0627\u0637 \u0642\u0648\u0629 \u062a\u0645 \u0645\u0644\u0627\u062d\u0638\u062a\u0647\u0627 \u0641\u064a \u0634\u062e\u0635\u064a\u0629 \u0627\u0644\u0645\u062a\u0637\u0648\u0639.<\/span> How would you describe the applicant? Please include any character strengths that you have noted.<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"how_wouldyoudescribe\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" name=\"how_wouldyoudescribe\"><\/textarea><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-md-12 col-sm-12\">\n\t\t\t<div class=\"form-group\">\n\t\t\t\t<p><label><span class=\"fr-br\">\u0647\u0644 \u062a\u0632\u0643\u064a \u0637\u0644\u0628 \u0627\u0644\u0645\u062a\u0642\u062f\u0645 \u0644\u0644\u062a\u0637\u0648\u0639 \u0641\u064a \u0627\u0644\u0645\u0633\u062a\u0634\u0641\u0649\u061f \u0647\u0644 \u0644\u062f\u064a\u0647 \u0627\u0644\u0642\u062f\u0631\u0629 \u0639\u0644\u0649 \u0627\u0644\u0639\u0645\u0644 \u0645\u0639 \u0627\u0644\u0623\u0637\u0641\u0627\u0644 \u0627\u0644\u0645\u0631\u0636\u0649 \u0648\u0645\u0639 \u0623\u0634\u062e\u0627\u0635 \u0645\u0646 \u062b\u0642\u0627\u0641\u0627\u062a \u0645\u062a\u0646\u0648\u0639\u0629\u061f<\/span> Would you recommend the applicant to work in a hospice\/hospital setting? Do they have the ability to work with sick children and with people of diverse cultures?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"would_yourecommendts\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" name=\"would_yourecommendts\"><\/textarea><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-md-12 col-sm-12\">\n\t\t\t<div class=\"form-group\">\n\t\t\t\t<p><label><span class=\"fr-br\">\u0639\u0644\u0649 \u0645\u0642\u064a\u0627\u0633 \u0645\u0646 1 \u0625\u0644\u0649 5 \u060c \u064a\u0631\u062c\u0649 \u062a\u0642\u064a\u064a\u0645 \u0645\u0642\u062f\u0645 \u0627\u0644\u0637\u0644\u0628 \u0645\u0646 \u0627\u0644\u0646\u0648\u0627\u062d\u064a \u0627\u0644\u062a\u0627\u0644\u064a\u0629:<\/span> On a scale from 1 to 5, please rate the applicant on the following traits:<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-md-6 col-sm-12\">\n\t\t\t<div class=\"form-group\">\n\t\t\t\t<p><label><span class=\"fr-br\">\u0627\u0645\u0643\u0627\u0646\u064a\u0629 \u0627\u0644\u0627\u0639\u062a\u0645\u0627\u062f \u0639\u0644\u0649 \u0627\u0644\u0645\u062a\u0637\u0648\u0639<\/span> Dependability<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"dependability\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"dependability\" value=\"1\" \/><span class=\"wpcf7-list-item-label\">1<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"dependability\" value=\"2\" \/><span class=\"wpcf7-list-item-label\">2<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"dependability\" value=\"3\" \/><span class=\"wpcf7-list-item-label\">3<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"dependability\" value=\"4\" \/><span class=\"wpcf7-list-item-label\">4<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"dependability\" value=\"5\" \/><span class=\"wpcf7-list-item-label\">5<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-md-6 col-sm-12\">\n\t\t\t<div class=\"form-group\">\n\t\t\t\t<p><label><span class=\"fr-br\">\u0627\u0644\u0645\u0631\u0648\u0646\u0629<\/span> Flexibility<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"flexibility\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"flexibility\" value=\"1\" \/><span class=\"wpcf7-list-item-label\">1<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"flexibility\" value=\"2\" \/><span class=\"wpcf7-list-item-label\">2<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"flexibility\" value=\"3\" \/><span class=\"wpcf7-list-item-label\">3<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"flexibility\" value=\"4\" \/><span class=\"wpcf7-list-item-label\">4<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"flexibility\" value=\"5\" \/><span class=\"wpcf7-list-item-label\">5<\/span><\/span><\/span><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-md-6 col-sm-12\">\n\t\t\t<div class=\"form-group\">\n\t\t\t\t<p><label><span class=\"fr-br\">\u0627\u0644\u0642\u062f\u0631\u0629 \u0639\u0644\u0649 \u0627\u0644\u0639\u0645\u0644 \u0636\u0645\u0646 \u0641\u0631\u064a\u0642 <\/span> Ability to work in a team<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ability_toworkinateam\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"ability_toworkinateam\" value=\"1\" \/><span class=\"wpcf7-list-item-label\">1<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"ability_toworkinateam\" value=\"2\" \/><span class=\"wpcf7-list-item-label\">2<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"ability_toworkinateam\" value=\"3\" \/><span class=\"wpcf7-list-item-label\">3<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"ability_toworkinateam\" value=\"4\" \/><span class=\"wpcf7-list-item-label\">4<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"ability_toworkinateam\" value=\"5\" \/><span class=\"wpcf7-list-item-label\">5<\/span><\/span><\/span><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-md-6 col-sm-12\">\n\t\t\t<div class=\"form-group\">\n\t\t\t\t<p><label><span class=\"fr-br\">\u0645\u0647\u0627\u0631\u0627\u062a \u0627\u0644\u062a\u0648\u0627\u0635\u0644 <\/span> Communication skills<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"communication_skills\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"communication_skills\" value=\"1\" \/><span class=\"wpcf7-list-item-label\">1<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"communication_skills\" value=\"2\" \/><span class=\"wpcf7-list-item-label\">2<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"communication_skills\" value=\"3\" \/><span class=\"wpcf7-list-item-label\">3<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"communication_skills\" value=\"4\" \/><span class=\"wpcf7-list-item-label\">4<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"communication_skills\" value=\"5\" \/><span class=\"wpcf7-list-item-label\">5<\/span><\/span><\/span><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-md-6 col-sm-12\">\n\t\t\t<div class=\"form-group\">\n\t\t\t\t<p><label><span class=\"fr-br\"> \u0627\u0644\u062d\u0645\u0627\u0633<\/span> Enthusiasm<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"enthusiasm\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"enthusiasm\" value=\"1\" \/><span class=\"wpcf7-list-item-label\">1<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"enthusiasm\" value=\"2\" \/><span class=\"wpcf7-list-item-label\">2<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"enthusiasm\" value=\"3\" \/><span class=\"wpcf7-list-item-label\">3<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"enthusiasm\" value=\"4\" \/><span class=\"wpcf7-list-item-label\">4<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"enthusiasm\" value=\"5\" \/><span class=\"wpcf7-list-item-label\">5<\/span><\/span><\/span><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-md-6 col-sm-12\">\n\t\t\t<div class=\"form-group\">\n\t\t\t\t<p><label><span class=\"fr-br\">\u0627\u0644\u0645\u0647\u0646\u064a\u0629 <\/span> Professionalism<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"professionalism\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"professionalism\" value=\"1\" \/><span class=\"wpcf7-list-item-label\">1<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"professionalism\" value=\"2\" \/><span class=\"wpcf7-list-item-label\">2<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"professionalism\" value=\"3\" \/><span class=\"wpcf7-list-item-label\">3<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"professionalism\" value=\"4\" \/><span class=\"wpcf7-list-item-label\">4<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"professionalism\" value=\"5\" \/><span class=\"wpcf7-list-item-label\">5<\/span><\/span><\/span><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-md-6 col-sm-12\">\n\t\t\t<div class=\"form-group\">\n\t\t\t\t<p><label><span class=\"fr-br\">\u0627\u0644\u0631\u062d\u0645\u0629 \u0648 \u0627\u0644\u062a\u0639\u0627\u0637\u0641 <\/span> Compassion<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"compassion\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"compassion\" value=\"1\" \/><span class=\"wpcf7-list-item-label\">1<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"compassion\" value=\"2\" \/><span class=\"wpcf7-list-item-label\">2<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"compassion\" value=\"3\" \/><span class=\"wpcf7-list-item-label\">3<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"compassion\" value=\"4\" \/><span class=\"wpcf7-list-item-label\">4<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"compassion\" value=\"5\" \/><span class=\"wpcf7-list-item-label\">5<\/span><\/span><\/span><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-md-6 col-sm-12\">\n\t\t\t<div class=\"form-group\">\n\t\t\t\t<p><label><span class=\"fr-br\">\u0627\u0644\u0635\u0628\u0631 <\/span> Patience<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"patience\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"patience\" value=\"1\" \/><span class=\"wpcf7-list-item-label\">1<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"patience\" value=\"2\" \/><span class=\"wpcf7-list-item-label\">2<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"patience\" value=\"3\" \/><span class=\"wpcf7-list-item-label\">3<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"patience\" value=\"4\" \/><span class=\"wpcf7-list-item-label\">4<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"patience\" value=\"5\" \/><span class=\"wpcf7-list-item-label\">5<\/span><\/span><\/span><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-md-12 col-sm-12\">\n\t\t\t<div class=\"fr-desc\">\n\t\t\t\t<h3 class=\"col_red\"><span class=\"fr-br\">\u064a\u0631\u062c\u0649 \u0627\u0644\u0639\u0644\u0645 \u0628\u0623\u0646 \u0627\u0644\u0645\u0639\u0644\u0648\u0645\u0627\u062a \u0627\u0644\u0648\u0627\u0631\u062f\u0629 \u0628\u0647\u0630\u0627 \u0627\u0644\u0646\u0645\u0648\u0630\u062c \u064a\u062c\u0628 \u0623\u0646 \u064a\u062a\u0645 \u0627\u0644\u062a\u0639\u0627\u0645\u0644 \u0645\u0639\u0647\u0627 \u0628\u0633\u0631\u064a\u0629 \u0648 \u062a\u0645 \u0645\u0634\u0627\u0631\u0643\u0629 \u0627\u0644\u0646\u0645\u0648\u0630\u062c \u0645\u0639\u0643 \u0639\u0644\u0649 \u0647\u0630\u0627 \u0627\u0644\u0623\u0633\u0627\u0633.<\/span> This form has been provided on the basis that it will be treated as confidential.\n\t\t\t\t<\/h3>\n\t\t\t\t<p><span class=\"fr-br\">\u0628\u0642\u0628\u0648\u0644\u0643 \u0644\u0625\u0643\u0645\u0627\u0644 \u0647\u0630\u0627 \u0627\u0644\u0646\u0645\u0648\u0630\u062c \u060c \u0641\u0625\u0646\u0643 \u062a\u0648\u0627\u0641\u0642 \u0648\u062a\u0642\u0631 \u0628\u0623\u0646 \u0623\u064a \u0645\u0639\u0644\u0648\u0645\u0627\u062a \u0648\u0627\u0631\u062f\u0629 \u0647\u0646\u0627 \u0635\u062d\u064a\u062d\u0629 \u0648\u064a\u062a\u0645 \u0627\u0644\u062a\u0639\u0627\u0645\u0644 \u0645\u0639\u0647\u0627 \u0639\u0644\u0649 \u0623\u0646\u0647\u0627 \u0633\u0631\u064a\u0629 \u060c \u0648\u0644\u0627 \u064a\u062c\u0648\u0632 \u0645\u0634\u0627\u0631\u0643\u062a\u0647\u0627 \u0645\u0639 \u0645\u0642\u062f\u0645 \u0627\u0644\u0637\u0644\u0628 \u0627\u0644\u0645\u062a\u0637\u0648\u0639 \u0648\u064a\u062c\u0628 \u062a\u0633\u0644\u064a\u0645\u0647\u0627 \u0645\u0628\u0627\u0634\u0631\u0629 \u0625\u0644\u0649 KACCH & BACCH.<\/span> By accepting to complete this form, you agree and acknowledge that any information contained herein is correct and is treated as confidential, and may not be shared with the volunteer applicant and should be delivered directly to KACCH & BACCH.\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-md-6 col-sm-12\">\n\t\t\t<div class=\"form-group\">\n\t\t\t\t<p><label><span class=\"fr-br\">\u0627\u0644\u062a\u0648\u0642\u064a\u0639 <\/span> Signature<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"signature\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"signature\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-md-6 col-sm-12\">\n\t\t\t<div class=\"form-group\">\n\t\t\t\t<p><label><span class=\"fr-br\">\u0627\u0644\u062a\u0627\u0631\u064a\u062e <\/span> Date<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"date\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control walcf7-datepicker\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"date\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-md-12 col-sm-12\">\n\t\t\t<div class=\"form-group text-center\">\n\t\t\t\t<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_eb_attr":"","footnotes":""},"class_list":["post-612","page","type-page","status-publish","hentry","entry"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.kacch.org\/mybrand-api\/wp\/v2\/pages\/612","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.kacch.org\/mybrand-api\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.kacch.org\/mybrand-api\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.kacch.org\/mybrand-api\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.kacch.org\/mybrand-api\/wp\/v2\/comments?post=612"}],"version-history":[{"count":4,"href":"https:\/\/www.kacch.org\/mybrand-api\/wp\/v2\/pages\/612\/revisions"}],"predecessor-version":[{"id":1111,"href":"https:\/\/www.kacch.org\/mybrand-api\/wp\/v2\/pages\/612\/revisions\/1111"}],"wp:attachment":[{"href":"https:\/\/www.kacch.org\/mybrand-api\/wp\/v2\/media?parent=612"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}