{"id":1305,"date":"2019-10-15T15:21:14","date_gmt":"2019-10-15T20:21:14","guid":{"rendered":"https:\/\/www.missouriwestern.edu\/staffassn\/?page_id=1305"},"modified":"2022-06-30T12:55:10","modified_gmt":"2022-06-30T17:55:10","slug":"hardship","status":"publish","type":"page","link":"https:\/\/www.missouriwestern.edu\/staffassn\/hardship\/","title":{"rendered":"Hardship Assistance Request"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-margin-top:15px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-justify-content-center fusion-flex-content-wrap\" style=\"max-width:calc( 100% + 0px );margin-left: calc(-0px \/ 2 );margin-right: calc(-0px \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:20px;--awb-spacing-left-large:0px;--awb-width-medium:100%;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1\"><p>If you have experienced an undue hardship at any time of year, please fill out this request and the Staff Association Care Committee will review your application as soon as possible.<\/p>\n<\/div><div class=\"fusion-text fusion-text-2\"><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 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         <div class='gform-body gform_body'><ul id='gform_fields_1' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_1_1\" class=\"gfield gfield--type-name 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 gfield_label_before_complex' >Staff Member&#039;s Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><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_1_1'>\n                            \n                            <span id='input_1_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_1_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_1_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_1_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_1_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_1_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_1_4\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Do you wish to remain anonymous?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_1_4'>If Yes, only Care Committee Co-Chairs will know applicant's identity.<\/div><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_1_4'>\n\t\t\t<li class='gchoice gchoice_1_4_0'>\n\t\t\t\t<input name='input_4' type='radio' value='Yes'  id='choice_1_4_0'    \/>\n\t\t\t\t<label for='choice_1_4_0' id='label_1_4_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_4_1'>\n\t\t\t\t<input name='input_4' type='radio' value='No'  id='choice_1_4_1'    \/>\n\t\t\t\t<label for='choice_1_4_1' id='label_1_4_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_1_5\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_5'>Position at ΄σΟσ΄«Γ½<\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_1_5' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_1_6\" class=\"gfield gfield--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_1_6'>Postal Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_1_6' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_1_7\" class=\"gfield gfield--type-phone 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_1_7'>Phone Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_7' id='input_1_7' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_1_8\" class=\"gfield gfield--type-email 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_1_8'>Email Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_8' id='input_1_8' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_1_9\" class=\"gfield gfield--type-textarea 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_1_9'>Please provide an explanation of your circumstance.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_9' id='input_1_9' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_1_10\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >In what specific ways can the Staff Association members help meet your needs?<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_1_10'><li class='gchoice gchoice_1_10_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.1' type='checkbox'  value='Meal Train'  id='choice_1_10_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_10_1' id='label_1_10_1' class='gform-field-label gform-field-label--type-inline'>Meal Train<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_10_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.2' type='checkbox'  value='Basic personal necessities'  id='choice_1_10_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_10_2' id='label_1_10_2' class='gform-field-label gform-field-label--type-inline'>Basic personal necessities<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_10_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.3' type='checkbox'  value='Clothing'  id='choice_1_10_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_10_3' id='label_1_10_3' class='gform-field-label gform-field-label--type-inline'>Clothing<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_10_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.4' type='checkbox'  value='CVS gift card'  id='choice_1_10_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_10_4' id='label_1_10_4' class='gform-field-label gform-field-label--type-inline'>CVS gift card<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_10_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.5' type='checkbox'  value='Gas for vehicle'  id='choice_1_10_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_10_5' id='label_1_10_5' class='gform-field-label gform-field-label--type-inline'>Gas for vehicle<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_10_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.6' type='checkbox'  value='Groceries'  id='choice_1_10_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_10_6' id='label_1_10_6' class='gform-field-label gform-field-label--type-inline'>Groceries<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_10_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.7' type='checkbox'  value='Prescription medicine'  id='choice_1_10_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_10_7' id='label_1_10_7' class='gform-field-label gform-field-label--type-inline'>Prescription medicine<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_10_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.8' type='checkbox'  value='Rent\/Mortgage'  id='choice_1_10_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_10_8' id='label_1_10_8' class='gform-field-label gform-field-label--type-inline'>Rent\/Mortgage<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_10_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.9' type='checkbox'  value='Rides to appointments'  id='choice_1_10_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_10_9' id='label_1_10_9' class='gform-field-label gform-field-label--type-inline'>Rides to appointments<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_10_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.11' type='checkbox'  value='Utilities'  id='choice_1_10_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_10_11' id='label_1_10_11' class='gform-field-label gform-field-label--type-inline'>Utilities<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_10_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.12' type='checkbox'  value='Vehicle repairs'  id='choice_1_10_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_10_12' id='label_1_10_12' class='gform-field-label gform-field-label--type-inline'>Vehicle repairs<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_10_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.13' type='checkbox'  value='Walmart gift card'  id='choice_1_10_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_10_13' id='label_1_10_13' class='gform-field-label gform-field-label--type-inline'>Walmart gift card<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_1_11\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_11'>Other<\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_1_11' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_1_12\" class=\"gfield gfield--type-radio gfield--type-choice 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' >Confirmation<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_1_12'>\n\t\t\t<li class='gchoice gchoice_1_12_0'>\n\t\t\t\t<input name='input_12' type='radio' value='I am the applicant seeking assistance'  id='choice_1_12_0'    \/>\n\t\t\t\t<label for='choice_1_12_0' id='label_1_12_0' class='gform-field-label gform-field-label--type-inline'>I am the applicant seeking assistance<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_12_1'>\n\t\t\t\t<input name='input_12' type='radio' value='I am nominating this applicant for assistance'  id='choice_1_12_1'    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