{"id":828,"date":"2023-02-15T16:32:37","date_gmt":"2023-02-15T16:32:37","guid":{"rendered":"https:\/\/research.uregina.ca\/cah\/?page_id=828"},"modified":"2024-04-05T15:57:42","modified_gmt":"2024-04-05T15:57:42","slug":"online-nomination-form","status":"publish","type":"page","link":"https:\/\/research.uregina.ca\/cah\/about-cah\/innovation-in-health-wellness-award\/online-nomination-form\/","title":{"rendered":"Online Nomination Form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"828\" class=\"elementor elementor-828\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-12fc16e e-con-full e-flex e-con e-parent\" data-id=\"12fc16e\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-0afa04c elementor-widget elementor-widget-template\" data-id=\"0afa04c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"template.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-template\">\n\t\t\t\t\t<div data-elementor-type=\"container\" data-elementor-id=\"832\" class=\"elementor elementor-832\" data-elementor-post-type=\"elementor_library\">\n\t\t\t\t<div class=\"elementor-element elementor-element-04f3a56 e-con-full e-flex e-con e-parent\" data-id=\"04f3a56\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div data-dce-field-description=\"{&quot;fields&quot;:[{&quot;custom_id&quot;:&quot;field_ebe618c&quot;,&quot;position&quot;:&quot;elementor-field&quot;,&quot;description&quot;:&quot;For &lt;strong&gt;Nominee Biography&lt;\\\/strong&gt;, please give a brief description of the nominee. Indicate in what capacity you know the nominee, details about their work or volunteer experience\\u2014their affiliation(s) and title(s)\\u2014and other details you feel are relevant to this award. &quot;,&quot;description_text&quot;:&quot;For Nominee Biography, please give a brief description of the nominee. Indicate in what capacity you know the nominee, details about their work or volunteer experience\\u2014their affiliation(s) and title(s)\\u2014and other details you feel are relevant to this award.&quot;},{&quot;custom_id&quot;:&quot;field_949154e&quot;,&quot;position&quot;:&quot;elementor-field&quot;,&quot;description&quot;:&quot;For &lt;strong&gt;Innovation Description&lt;\\\/strong&gt;, please describe the innovation, the impact of the innovation, and the reasons why the innovation is significant to services or programs for older adults.&quot;,&quot;description_text&quot;:&quot;For Innovation Description, please describe the innovation, the impact of the innovation, and the reasons why the innovation is significant to services or programs for older adults.&quot;},{&quot;custom_id&quot;:&quot;field_b9dda8a&quot;,&quot;position&quot;:&quot;elementor-field&quot;,&quot;description&quot;:&quot;&lt;strong&gt;I agree to submit this application&lt;\\\/strong&gt;, which will now be sent to the adjudication committee. The information presented is accurate and I agree to be contacted should the committee need further information or clarification. I have attached letters of support and have completed the nominee biography and a short description of their innovation.  &quot;,&quot;description_text&quot;:&quot;I agree to submit this application, which will now be sent to the adjudication committee. The information presented is accurate and I agree to be contacted should the committee need further information or clarification. I have attached letters of support and have completed the nominee biography and a short description of their innovation.&quot;}]}\" class=\"elementor-element elementor-element-9ed3031 elementor-button-align-center elementor-widget elementor-widget-form\" data-id=\"9ed3031\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Next step&quot;,&quot;step_previous_label&quot;:&quot;Previous step&quot;,&quot;step_type&quot;:&quot;text&quot;,&quot;dce_confirm_dialog_enabled&quot;:&quot;no&quot;,&quot;label_icon_size&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;field_icon_size&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]}}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" name=\"Nomination Form - CAH Award\" aria-label=\"Nomination Form - CAH Award\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"832\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"9ed3031\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"Centre on Aging and Health\" \/>\n\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-step elementor-field-group elementor-column elementor-field-group-nominee_info elementor-col-100\">\n\t\t\t\t\t\t\t<div class=\"e-field-step elementor-hidden\" data-label=\"Nominee Information\" data-previousButton=\"\" data-nextButton=\"\" data-iconUrl=\"\" data-iconLibrary=\"fas fa-star\" data-icon=\"\" ><\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_3dd74e5 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_3dd74e5\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tName\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_3dd74e5]\" id=\"form-field-field_3dd74e5\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text\">\n\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_8dc6cb3]\" id=\"form-field-field_8dc6cb3\" class=\"elementor-field elementor-size-sm \" style=\"display:none !important;\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_ee1a3f1 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_ee1a3f1\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAddress\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_ee1a3f1]\" id=\"form-field-field_ee1a3f1\" rows=\"5\" required=\"required\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-field_46a4570 elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_46a4570\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tEmail\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[field_46a4570]\" id=\"form-field-field_46a4570\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-tel elementor-field-group elementor-column elementor-field-group-field_a5dac0a elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_a5dac0a\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tTelephone\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input size=\"1\" type=\"tel\" name=\"form_fields[field_a5dac0a]\" id=\"form-field-field_a5dac0a\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Only numbers and phone characters (#, -, *, etc) are accepted.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_ebe618c elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_ebe618c\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tNominee Biography\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_ebe618c]\" id=\"form-field-field_ebe618c\" rows=\"5\" required=\"required\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_949154e elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_949154e\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tInnovation Description\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_949154e]\" id=\"form-field-field_949154e\" rows=\"5\" required=\"required\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-upload elementor-field-group elementor-column elementor-field-group-field_d94e62b elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_d94e62b\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPlease attach letters of support or other info in PDF format\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input type=\"file\" name=\"form_fields[field_d94e62b][]\" id=\"form-field-field_d94e62b\" class=\"elementor-field elementor-size-sm  elementor-upload-field\" required=\"required\" multiple=\"multiple\" data-maxsize=\"10\" data-maxsize-message=\"This file exceeds the maximum allowed size.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-step elementor-field-group elementor-column elementor-field-group-nominator_info elementor-col-100\">\n\t\t\t\t\t\t\t<div class=\"e-field-step elementor-hidden\" data-label=\"Nominator Information\" data-previousButton=\"\" data-nextButton=\"\" data-iconUrl=\"\" data-iconLibrary=\"fas fa-star\" data-icon=\"\" ><\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_a812680 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_a812680\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tName\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_a812680]\" id=\"form-field-field_a812680\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text\">\n\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_94961d5]\" id=\"form-field-field_94961d5\" class=\"elementor-field elementor-size-sm \" style=\"display:none !important;\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-field_62cd398 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_62cd398\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tEmail\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[field_62cd398]\" id=\"form-field-field_62cd398\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-tel elementor-field-group elementor-column elementor-field-group-field_b9dda8a elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_b9dda8a\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPhone\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input size=\"1\" type=\"tel\" name=\"form_fields[field_b9dda8a]\" id=\"form-field-field_b9dda8a\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Only numbers and phone characters (#, -, *, etc) are accepted.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-acceptance elementor-field-group elementor-column elementor-field-group-field_9a555eb elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_9a555eb\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tTerms Acceptance\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-subgroup\">\n\t\t\t<span class=\"elementor-field-option\">\n\t\t\t\t<input type=\"checkbox\" name=\"form_fields[field_9a555eb]\" id=\"form-field-field_9a555eb\" class=\"elementor-field elementor-size-sm  elementor-acceptance-field\" required=\"required\">\n\t\t\t\t<label for=\"form-field-field_9a555eb\">Yes. I have read the above agreement and accept the terms as presented.<\/label>\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-sm\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Submit<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t<style>.elementor-element.elementor-element-9ed3031 .elementor-field-group { align-self: flex-start; }<\/style>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":803,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-828","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/research.uregina.ca\/cah\/wp-json\/wp\/v2\/pages\/828","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/research.uregina.ca\/cah\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/research.uregina.ca\/cah\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/research.uregina.ca\/cah\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/research.uregina.ca\/cah\/wp-json\/wp\/v2\/comments?post=828"}],"version-history":[{"count":12,"href":"https:\/\/research.uregina.ca\/cah\/wp-json\/wp\/v2\/pages\/828\/revisions"}],"predecessor-version":[{"id":2627,"href":"https:\/\/research.uregina.ca\/cah\/wp-json\/wp\/v2\/pages\/828\/revisions\/2627"}],"up":[{"embeddable":true,"href":"https:\/\/research.uregina.ca\/cah\/wp-json\/wp\/v2\/pages\/803"}],"wp:attachment":[{"href":"https:\/\/research.uregina.ca\/cah\/wp-json\/wp\/v2\/media?parent=828"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}