{"id":17857,"date":"2025-09-16T17:00:39","date_gmt":"2025-09-16T21:00:39","guid":{"rendered":"https:\/\/readtogrow.org\/formulaire-de-demande-de-bibliobus\/"},"modified":"2025-09-22T20:11:40","modified_gmt":"2025-09-23T00:11:40","slug":"formulaire-de-demande-de-bibliobus","status":"publish","type":"page","link":"https:\/\/readtogrow.org\/fr\/formulaire-de-demande-de-bibliobus\/","title":{"rendered":"Formulaire de demande de bibliobus"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"17857\" class=\"elementor elementor-17857 elementor-11415\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4c740f6a page-header e-flex e-con-boxed wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no e-con e-parent\" data-id=\"4c740f6a\" data-element_type=\"container\" data-e-type=\"container\" id=\"page-header\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4879304d elementor-widget elementor-widget-text-editor\" data-id=\"4879304d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h1>Formulaire de demande de bibliobus<\/h1>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-4c9d8d46 form e-flex e-con-boxed wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no e-con e-parent\" data-id=\"4c9d8d46\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-752661ba e-flex e-con-boxed wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no e-con e-child\" data-id=\"752661ba\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-14cdecb7 elementor-widget elementor-widget-text-editor\" data-id=\"14cdecb7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3>Un passage de la bibliobus vous int\u00e9resse-t-il&nbsp;?<\/h3><p>Si vous souhaitez que le bibliobus Read to Grow se rende dans votre \u00e9cole, programme ou \u00e9v\u00e9nement communautaire, veuillez remplir le formulaire de demande ci-dessous. Bien que nous fassions de notre mieux pour r\u00e9pondre au plus grand nombre de demandes possible, nous ne pouvons pas garantir la disponibilit\u00e9. Un membre de notre \u00e9quipe vous contactera apr\u00e8s avoir examin\u00e9 votre demande.  <\/p><p>Si vous avez des questions, n\u2019h\u00e9sitez pas \u00e0 nous contacter \u00e0 l\u2019adresse <a href=\"mailto:bookmobile@readtogrow.org\">bookmobile@readtogrow.org<\/a>. Nous vous remercions de votre int\u00e9r\u00eat \u00e0 apporter la joie des livres \u00e0 votre communaut\u00e9&nbsp;! <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9f4935d elementor-widget elementor-widget-shortcode\" data-id=\"9f4935d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><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 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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_34' style='display:none'>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Formulaire de demande de bibliobus<\/h2>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>\u00ab\u00a0<span class=\"gfield_required gfield_required_asterisk\">*<\/span>\u00a0\u00bb indique les champs n\u00e9cessaires<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_34'  action='\/fr\/wp-json\/wp\/v2\/pages\/17857' data-formid='34' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_34' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_34_88\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_34_1\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >(<span class=\"red\">*<\/span> indique les champs obligatoires)<\/div><div id=\"field_34_115\" 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\"  >(<span class=\"red\">*<\/span> denotes required fields)<\/div><div id=\"field_34_95\" 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\"  ><h1>Organization And Contact Information<h1><\/div><div id=\"field_34_67\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half 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_34_67'>Pr\u00e9nom&nbsp;:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_67' id='input_34_67' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_34_68\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half 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_34_68'>Nom&nbsp;:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_68' id='input_34_68' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_34_5\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half 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_34_5'>Nom de l&#039;organisation&nbsp;:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_34_5' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_34_48\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half 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_34_48'>Votre titre&nbsp;:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_48' id='input_34_48' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_34_70\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half 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_34_70'>Adresse&nbsp;:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_70' id='input_34_70' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_34_71\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half 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_34_71'>Adresse 2&nbsp;:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_71' id='input_34_71' type='text' value='' class='large'  aria-describedby=\"gfield_description_34_71\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_34_71'>Street address where Bookmobile should park.<\/div><\/div><div id=\"field_34_72\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter 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_34_72'>Ville :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_72' id='input_34_72' type='text' value='' class='large'  aria-describedby=\"gfield_description_34_72\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_34_72'>City where the Bookmobile event is taking place.<\/div><\/div><div id=\"field_34_73\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-quarter html-label gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p>\u00c9tat :<\/p>\n<p>CONNECTICUT<\/p><\/div><div id=\"field_34_74\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter 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_34_74'>Code postal :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_74' id='input_34_74' type='text' value='' class='large'  aria-describedby=\"gfield_description_34_74\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_34_74'>ZIP Code where the Bookmobile event is taking place.<\/div><\/div><div id=\"field_34_75\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter 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_34_75'>Comt\u00e9 :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_75' id='input_34_75' class='large gfield_select'  aria-describedby=\"gfield_description_34_75\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Choisir\u2026<\/option><option value='Fairfield' >Fairfield<\/option><option value='Hartford' >Hartford<\/option><option value='Litchfield' >Litchfield<\/option><option value='Middlesex' >Middlesex<\/option><option value='New Haven' >New Haven<\/option><option value='New London' >New London<\/option><option value='Tolland' >Tolland<\/option><option value='Windham' >Windham<\/option><\/select><\/div><div class='gfield_description' id='gfield_description_34_75'>County where the Bookmobile event is taking place.<\/div><\/div><div id=\"field_34_76\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half 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_34_76'>T\u00e9l\u00e9phone du programme&nbsp;:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_76' id='input_34_76' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_34_77\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half 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_34_77'>T\u00e9l\u00e9phone fixe\/portable&nbsp;:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_77' id='input_34_77' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_34_26\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half 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_34_26'>Courriel&nbsp;:<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_26' id='input_34_26' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_34_78\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half 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_34_78'>Pr\u00e9f\u00e9rence de langue pour les livres :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_78' id='input_34_78' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_34_89\" class=\"gfield gfield--type-select gfield--input-type-select 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_34_89'>Comment avez-vous entendu parler de Read to Grow&nbsp;?<\/label><div class='ginput_container ginput_container_select'><select name='input_89' id='input_34_89' class='large gfield_select'     aria-invalid=\"false\" ><option value='Bibliobus' >Bibliobus<\/option><option value='\u00c9v\u00e9nement communautaire' >\u00c9v\u00e9nement communautaire<\/option><option value='Ami \/ membre de la famille' >Ami \/ membre de la famille<\/option><option value='Visiteur \u00e0 domicile' >Visiteur \u00e0 domicile<\/option><option value='\u00c0 l&#039;h\u00f4pital lors de la naissance de mon b\u00e9b\u00e9' >\u00c0 l&#039;h\u00f4pital lors de la naissance de mon b\u00e9b\u00e9<\/option><option value='Biblioth\u00e8que' >Biblioth\u00e8que<\/option><option value='M\u00e9dias (t\u00e9l\u00e9vision, journaux, etc.)' >M\u00e9dias (t\u00e9l\u00e9vision, journaux, etc.)<\/option><option value='Clinique pr\u00e9natale' >Clinique pr\u00e9natale<\/option><option value='\u00c9v\u00e9nement Read to Grow' >\u00c9v\u00e9nement Read to Grow<\/option><option value='M\u00e9dias sociaux\/Internet' >M\u00e9dias sociaux\/Internet<\/option><option value='Enseignant \/ prestataire de services de garde d&#039;enfants' >Enseignant \/ prestataire de services de garde d&#039;enfants<\/option><option value='Autre' >Autre<\/option><\/select><\/div><\/div><fieldset id=\"field_34_81\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gf_list_inline 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' >Avez-vous d\u00e9j\u00e0 demand\u00e9 des livres&nbsp;?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_34_81'>\n\t\t\t<div class='gchoice gchoice_34_81_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_81' type='radio' value='Oui'  id='choice_34_81_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_81_0' id='label_34_81_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_34_81_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_81' type='radio' value='Non'  id='choice_34_81_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_81_1' id='label_34_81_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_34_85\" 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_34_85'>Quand avez-vous fait votre derni\u00e8re demande de livres&nbsp;?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_85' id='input_34_85' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/jj\/aaaa' aria-describedby=\"input_34_85_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_34_85_date_format' class='screen-reader-text'>MM slash JJ slash AAAA<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_34_85' class='gform_hidden' value='https:\/\/readtogrow.org\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><fieldset id=\"field_34_80\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gf_list_inline 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' >\u00cates-vous un partenaire de Reach Out and Read (ROAR)&nbsp;?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_34_80'>\n\t\t\t<div class='gchoice gchoice_34_80_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_80' type='radio' value='Oui'  id='choice_34_80_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_80_0' id='label_34_80_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_34_80_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_80' type='radio' value='Non'  id='choice_34_80_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_80_1' id='label_34_80_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_34_32\" 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' >Type d\u2019organisme&nbsp;:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_34_32'>\n\t\t\t<div class='gchoice gchoice_34_32_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='Entreprise\/soci\u00e9t\u00e9'  id='choice_34_32_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_32_0' id='label_34_32_0' class='gform-field-label gform-field-label--type-inline'>Entreprise\/soci\u00e9t\u00e9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_34_32_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='Organisme communautaire'  id='choice_34_32_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_32_1' id='label_34_32_1' class='gform-field-label gform-field-label--type-inline'>Organisme communautaire<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_34_32_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='Centre de la petite enfance \/ de l&#039;enfance'  id='choice_34_32_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_32_2' id='label_34_32_2' class='gform-field-label gform-field-label--type-inline'>Centre de la petite enfance \/ de l'enfance<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_34_32_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='Garde-manger'  id='choice_34_32_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_32_3' id='label_34_32_3' class='gform-field-label gform-field-label--type-inline'>Garde-manger<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_34_32_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='Organisme gouvernemental'  id='choice_34_32_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_32_4' id='label_34_32_4' class='gform-field-label gform-field-label--type-inline'>Organisme gouvernemental<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_34_32_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='Fournisseur de soins de sant\u00e9'  id='choice_34_32_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_32_5' id='label_34_32_5' class='gform-field-label gform-field-label--type-inline'>Fournisseur de soins de sant\u00e9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_34_32_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='Biblioth\u00e8que'  id='choice_34_32_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_32_6' id='label_34_32_6' class='gform-field-label gform-field-label--type-inline'>Biblioth\u00e8que<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_34_32_7'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='\u00c9cole'  id='choice_34_32_7' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_32_7' id='label_34_32_7' class='gform-field-label gform-field-label--type-inline'>\u00c9cole<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_34_32_8'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='Autre'  id='choice_34_32_8' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_32_8' id='label_34_32_8' class='gform-field-label gform-field-label--type-inline'>Autre<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_34_17\" 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_34_17'>Si autre, veuillez pr\u00e9ciser&nbsp;:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_17' id='input_34_17' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_34_79\" 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_34_79'>Quel district scolaire votre organisme dessert-il principalement&nbsp;?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_79' id='input_34_79' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_34_96\" 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\"  ><h1>Event Details And Scheduling<h1><\/div><div id=\"field_34_97\" 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\"  ><h5>Please Note: Bookmobile visits typically accommodate 30-200 children. Requests outside this range may be considered based on program capacity and community needs.<h5><\/div><div id=\"field_34_51\" 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_34_51'>Courriel du directeur\/de la directrice&nbsp;:<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_51' id='input_34_51' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_34_53\" 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_34_53'>Courriel du directeur\/de la directrice&nbsp;:<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_53' id='input_34_53' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_34_62\" 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\"  >Autres niveaux, veuillez contacter <a href=\"mailto:%20bookmobile@readtogrow.org\">bookmobile@readtogrow.org<\/a><\/div><div id=\"field_34_108\" 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_34_108'>Approximately how many children will participate?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_108' id='input_34_108' type='number' step='any'   value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_34_109\" 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_34_109'>What are the ages or grade levels of these children?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_109' id='input_34_109' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_34_34\" 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_34_34'>Si autre, veuillez pr\u00e9ciser&nbsp;:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_34' id='input_34_34' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_34_83\" 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_34_83'>Si vous ne connaissez pas Read to Grow, veuillez d\u00e9crire votre programme&nbsp;:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_83' id='input_34_83' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_34_117\" 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\"  >\n<div class=\"custom-date-picker\">\n\n  <p class=\"date-notice\">\n    The Bookmobile is fully booked for Read Across America Week,\n    March 2\u20137. Please select an alternate date when submitting\n    your request.\n  <\/p>\n\n  <label for=\"custom_date\">Choose a date:<\/label>\n\n  <input\n    type=\"date\"\n    id=\"custom_date\"\n    name=\"custom_date\"\n    min=\"2027-01-01\"\n    value=\"2027-01-01\"\n  >\n\n<\/div>\n\n<style>\n  .custom-date-picker {\n    margin: 15px 0;\n  }\n\n  .date-notice {\n    background-color: #fff4e5;\n    border-left: 4px solid #d97706;\n    padding: 12px 15px;\n    margin-bottom: 18px;\n    line-height: 1.5;\n    color: #333333;\n    font-size: 15px;\n  }\n\n  .custom-date-picker label {\n    display: block;\n    margin-bottom: 8px;\n    font-weight: 600;\n  }\n\n  .custom-date-picker input {\n    padding: 10px;\n    width: 100%;\n    max-width: 350px;\n    box-sizing: border-box;\n  }\n<\/style>\n<\/div><div id=\"field_34_84\" 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_34_84'>Heure de l&#039;\u00e9v\u00e9nement&nbsp;:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_84' id='input_34_84' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Choisir\u2026<\/option><option value='Matin (9&nbsp;h&nbsp;00 - 11&nbsp;h&nbsp;00)' >Matin (9&nbsp;h&nbsp;00 - 11&nbsp;h&nbsp;00)<\/option><option value='Apr\u00e8s-midi (12&nbsp;h&nbsp;00 - 15&nbsp;h&nbsp;30)' >Apr\u00e8s-midi (12&nbsp;h&nbsp;00 - 15&nbsp;h&nbsp;30)<\/option><option value='Apr\u00e8s l&#039;\u00e9cole (16&nbsp;h&nbsp;00 ou plus tard)' >Apr\u00e8s l&#039;\u00e9cole (16&nbsp;h&nbsp;00 ou plus tard)<\/option><\/select><\/div><\/div><fieldset id=\"field_34_52\" class=\"gfield gfield--type-time gfield--input-type-time gfield--width-third 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' >Heure d&#039;installation de l&#039;\u00e9v\u00e9nement&nbsp;:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/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_34_52'>\n                            <input type='number' name='input_52[]' id='input_34_52_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_34_52_1'>Heures<\/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_52[]' id='input_34_52_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_34_52_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_52[]' id='input_34_52_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_34_52_3'>AM\/PM<\/label>                                \n                           <\/div>\n                    <\/div><\/fieldset><fieldset id=\"field_34_30\" class=\"gfield gfield--type-time gfield--input-type-time gfield--width-third 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' >Heure de d\u00e9but de l&#039;\u00e9v\u00e9nement&nbsp;:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/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_34_30'>\n                            <input type='number' name='input_30[]' id='input_34_30_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_34_30_1'>Heures<\/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_30[]' id='input_34_30_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_34_30_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_30[]' id='input_34_30_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_34_30_3'>AM\/PM<\/label>                                \n                           <\/div>\n                    <\/div><\/fieldset><fieldset id=\"field_34_31\" class=\"gfield gfield--type-time gfield--input-type-time gfield--width-third 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' >Heure de fin de l&#039;\u00e9v\u00e9nement&nbsp;:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/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_34_31'>\n                            <input type='number' name='input_31[]' id='input_34_31_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_34_31_1'>Heures<\/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_31[]' id='input_34_31_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_34_31_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_31[]' id='input_34_31_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_34_31_3'>AM\/PM<\/label>                                \n                           <\/div>\n                    <\/div><\/fieldset><div id=\"field_34_90\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-half 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_34_90'>Alternate Date #1:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_90' id='input_34_90' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/jj\/aaaa' aria-describedby=\"input_34_90_date_format gfield_description_34_90\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_34_90_date_format' class='screen-reader-text'>MM slash JJ slash AAAA<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_34_90' class='gform_hidden' value='https:\/\/readtogrow.org\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><div class='gfield_description' id='gfield_description_34_90'>Please select an alternate date, if available. If your event date is fixed, enter your original event date again.<\/div><\/div><div id=\"field_34_91\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-half 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_34_91'>Alternate Date #2:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_91' id='input_34_91' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/jj\/aaaa' aria-describedby=\"input_34_91_date_format gfield_description_34_91\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_34_91_date_format' class='screen-reader-text'>MM slash JJ slash AAAA<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_34_91' class='gform_hidden' value='https:\/\/readtogrow.org\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><div class='gfield_description' id='gfield_description_34_91'>Please select a second alternate date, if available. If your event date is fixed, enter your original event date again.\u00a0<\/div><\/div><fieldset id=\"field_34_113\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Will participants be able to visit the Bookmobile in the event of rain or other inclement weather?\u00a0<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_34_113'>\n\t\t\t<div class='gchoice gchoice_34_113_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_113' type='radio' value='Yes'  id='choice_34_113_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_34_113\"   \/>\n\t\t\t\t\t<label for='choice_34_113_0' id='label_34_113_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_34_113_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_113' type='radio' value='No'  id='choice_34_113_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_113_1' id='label_34_113_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_34_113_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_113' type='radio' value='Not sure yet'  id='choice_34_113_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_113_2' id='label_34_113_2' class='gform-field-label gform-field-label--type-inline'>Not sure yet<\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_34_113'>Please note: The Bookmobile is an outdoor experience. If your organization chooses to cancel due to weather or other circumstances, rescheduling is subject to availability and may take several weeks.\u00a0<\/div><\/fieldset><div id=\"field_34_116\" 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\"  ><h5>Cancellations and Changes: We understand that plans change! If you need to cancel or reschedule your event, please notify us as soon as possible, ideally at least 48 hours in advance. If Read to Grow must cancel due to unsafe weather or road conditions, we will work with you to find an alternate date as soon as possible.<h5><\/div><div id=\"field_34_114\" 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\"  ><h1>Participants and Visit Planning<h1><\/div><fieldset id=\"field_34_33\" 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' >Quel type d&#039;\u00e9v\u00e9nement pr\u00e9voyez-vous&nbsp;?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_34_33'>\n\t\t\t<div class='gchoice gchoice_34_33_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='Seulement le bibliobus'  id='choice_34_33_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_33_0' id='label_34_33_0' class='gform-field-label gform-field-label--type-inline'>Seulement le bibliobus<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_34_33_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='\u00c9v\u00e9nement communautaire avec d&#039;autres fournisseurs'  id='choice_34_33_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_33_1' id='label_34_33_1' class='gform-field-label gform-field-label--type-inline'>\u00c9v\u00e9nement communautaire avec d'autres fournisseurs<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_34_33_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='\u00c9v\u00e9nement de sant\u00e9 avec d&#039;autres fournisseurs'  id='choice_34_33_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_33_2' id='label_34_33_2' class='gform-field-label gform-field-label--type-inline'>\u00c9v\u00e9nement de sant\u00e9 avec d'autres fournisseurs<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_34_33_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='Banque alimentaire'  id='choice_34_33_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_33_3' id='label_34_33_3' class='gform-field-label gform-field-label--type-inline'>Banque alimentaire<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_34_33_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='\u00c9v\u00e9nement d&#039;alphab\u00e9tisation avec d&#039;autres ressources\/fournisseurs'  id='choice_34_33_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_33_4' id='label_34_33_4' class='gform-field-label gform-field-label--type-inline'>\u00c9v\u00e9nement d'alphab\u00e9tisation avec d'autres ressources\/fournisseurs<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_34_33_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='Autre'  id='choice_34_33_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_33_5' id='label_34_33_5' class='gform-field-label gform-field-label--type-inline'>Autre<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_34_100\" 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' >Who is the primary audience for this event?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_34_100'>\n\t\t\t<div class='gchoice gchoice_34_100_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_100' type='radio' value='Children (i.e. Schools, Childcare Programs, etc.)\u00a0'  id='choice_34_100_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_100_0' id='label_34_100_0' class='gform-field-label gform-field-label--type-inline'>Children (i.e. Schools, Childcare Programs, etc.)\u00a0<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_34_100_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_100' type='radio' value='Children and Families'  id='choice_34_100_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_100_1' id='label_34_100_1' class='gform-field-label gform-field-label--type-inline'>Children and Families<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_34_100_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_100' type='radio' value='General Community \/ All Ages'  id='choice_34_100_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_100_2' id='label_34_100_2' class='gform-field-label gform-field-label--type-inline'>General Community \/ All Ages<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_34_100_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_100' type='radio' value='Other'  id='choice_34_100_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_100_3' id='label_34_100_3' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_34_38\" 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_34_38'>Si autre, veuillez pr\u00e9ciser&nbsp;:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_38' id='input_34_38' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_34_110\" 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\"  ><h3 style=\"margin-bottom: 10px;\">Approximately how many students will participate at each grade level? <\/h3>\n<style>\n  .childcare-grade-table {\n    width: 100%;\n    border-collapse: collapse;\n    margin: 15px 0;\n    font-size: 15px;\n  }\n\n  .childcare-grade-table th,\n  .childcare-grade-table td {\n    border: 1px solid #ccc;\n    padding: 10px;\n    text-align: left;\n  }\n\n  .childcare-grade-table th {\n    background-color: #f2f2f2;\n    font-weight: bold;\n  }\n\n  .childcare-grade-table input {\n    width: 100%;\n    max-width: 150px;\n    box-sizing: border-box;\n    padding: 8px;\n  }\n\n  .childcare-grade-table .total-row {\n    background-color: #f7f7f7;\n    font-weight: bold;\n  }\n\n  .childcare-grade-table .total-value {\n    padding: 8px;\n    display: inline-block;\n  }\n<\/style>\n\n<table class=\"childcare-grade-table\" id=\"childcare-grade-table\">\n  <thead>\n    <tr>\n      <th scope=\"col\">Grade Level<\/th>\n      <th scope=\"col\">Number of Children<\/th>\n      <th scope=\"col\">Number of Classrooms<\/th>\n    <\/tr>\n  <\/thead>\n  <tbody>\n    <tr>\n      <td>Infants<\/td>\n      <td>\n        <input type=\"number\" min=\"0\" step=\"1\"\n          name=\"infants_children\" id=\"infants_children\"\n          aria-label=\"Infants number of children\">\n      <\/td>\n      <td>\n        <input type=\"number\" min=\"0\" step=\"1\"\n          name=\"infants_classrooms\" id=\"infants_classrooms\"\n          aria-label=\"Infants number of classrooms\">\n      <\/td>\n    <\/tr>\n    <tr>\n      <td>Toddlers<\/td>\n      <td>\n        <input type=\"number\" min=\"0\" step=\"1\"\n          name=\"toddlers_children\" id=\"toddlers_children\"\n          aria-label=\"Toddlers number of children\">\n      <\/td>\n      <td>\n        <input type=\"number\" min=\"0\" step=\"1\"\n          name=\"toddlers_classrooms\" id=\"toddlers_classrooms\"\n          aria-label=\"Toddlers number of classrooms\">\n      <\/td>\n    <\/tr>\n    <tr>\n      <td>Pre-K<\/td>\n      <td>\n        <input type=\"number\" min=\"0\" step=\"1\"\n          name=\"prek_children\" id=\"prek_children\"\n          aria-label=\"Pre-K number of children\">\n      <\/td>\n      <td>\n        <input type=\"number\" min=\"0\" step=\"1\"\n          name=\"prek_classrooms\" id=\"prek_classrooms\"\n          aria-label=\"Pre-K number of classrooms\">\n      <\/td>\n    <\/tr>\n    <tr class=\"total-row\">\n      <td>Total<\/td>\n      <td>\n        <span class=\"total-value\" id=\"total_children\">0<\/span>\n      <\/td>\n      <td>\n        <span class=\"total-value\" id=\"total_classrooms\">0<\/span>\n      <\/td>\n    <\/tr>\n  <\/tbody>\n<\/table>\n\n<script>\n(function () {\n  var table = document.getElementById('childcare-grade-table');\n  if (!table) return;\n\n  function updateTotals() {\n    var childFields = [\n      'infants_children',\n      'toddlers_children',\n      'prek_children'\n    ];\n\n    var classroomFields = [\n      'infants_classrooms',\n      'toddlers_classrooms',\n      'prek_classrooms'\n    ];\n\n    function sumFields(ids) {\n      return ids.reduce(function (sum, id) {\n        var field = table.querySelector('#' + id);\n        return sum + (field ? (parseInt(field.value, 10) || 0) : 0);\n      }, 0);\n    }\n\n    table.querySelector('#total_children').textContent =\n      sumFields(childFields);\n\n    table.querySelector('#total_classrooms').textContent =\n      sumFields(classroomFields);\n  }\n\n  table.addEventListener('input', updateTotals);\n  updateTotals();\n})();\n<\/script>\n<\/div><div id=\"field_34_111\" 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\"  ><h3 style=\"margin-bottom: 10px;\">Approximately how many people will participate at each grade level? <\/h3>\n<style>\n  .age-bracket-table {\n    width: 100%;\n    border-collapse: collapse;\n    margin: 15px 0;\n    font-size: 15px;\n  }\n\n  .age-bracket-table th,\n  .age-bracket-table td {\n    border: 1px solid #ccc;\n    padding: 10px;\n    text-align: left;\n  }\n\n  .age-bracket-table th {\n    background-color: #f2f2f2;\n    font-weight: bold;\n  }\n\n  .age-bracket-table input {\n    width: 100%;\n    max-width: 150px;\n    box-sizing: border-box;\n    padding: 8px;\n  }\n\n  .age-bracket-table .total-row {\n    background-color: #f7f7f7;\n    font-weight: bold;\n  }\n\n  .age-bracket-table .total-value {\n    padding: 8px;\n    display: inline-block;\n  }\n<\/style>\n\n<table class=\"age-bracket-table\" id=\"age-bracket-table\">\n  <thead>\n    <tr>\n      <th scope=\"col\">Age Bracket<\/th>\n      <th scope=\"col\">Number of People<\/th>\n    <\/tr>\n  <\/thead>\n  <tbody>\n    <tr>\n      <td>0\u20132 Years<\/td>\n      <td>\n        <input type=\"number\" min=\"0\" step=\"1\"\n          name=\"age_0_2\" id=\"age_0_2\"\n          aria-label=\"Number of people aged 0 to 2 years\">\n      <\/td>\n    <\/tr>\n    <tr>\n      <td>3\u20137 Years<\/td>\n      <td>\n        <input type=\"number\" min=\"0\" step=\"1\"\n          name=\"age_3_7\" id=\"age_3_7\"\n          aria-label=\"Number of people aged 3 to 7 years\">\n      <\/td>\n    <\/tr>\n    <tr>\n      <td>8\u201311 Years<\/td>\n      <td>\n        <input type=\"number\" min=\"0\" step=\"1\"\n          name=\"age_8_11\" id=\"age_8_11\"\n          aria-label=\"Number of people aged 8 to 11 years\">\n      <\/td>\n    <\/tr>\n    <tr>\n      <td>12\u201317 Years<\/td>\n      <td>\n        <input type=\"number\" min=\"0\" step=\"1\"\n          name=\"age_12_17\" id=\"age_12_17\"\n          aria-label=\"Number of people aged 12 to 17 years\">\n      <\/td>\n    <\/tr>\n    <tr>\n      <td>18+<\/td>\n      <td>\n        <input type=\"number\" min=\"0\" step=\"1\"\n          name=\"age_18_plus\" id=\"age_18_plus\"\n          aria-label=\"Number of people aged 18 and older\">\n      <\/td>\n    <\/tr>\n    <tr class=\"total-row\">\n      <td>Total People<\/td>\n      <td>\n        <span class=\"total-value\" id=\"total_people\">0<\/span>\n      <\/td>\n    <\/tr>\n  <\/tbody>\n<\/table>\n\n<script>\n(function () {\n  var table = document.getElementById('age-bracket-table');\n  if (!table) return;\n\n  function updateTotal() {\n    var fields = [\n      'age_0_2',\n      'age_3_7',\n      'age_8_11',\n      'age_12_17',\n      'age_18_plus'\n    ];\n\n    var total = fields.reduce(function (sum, id) {\n      var field = table.querySelector('#' + id);\n      return sum + (field ? (parseInt(field.value, 10) || 0) : 0);\n    }, 0);\n\n    table.querySelector('#total_people').textContent = total;\n  }\n\n  table.addEventListener('input', updateTotal);\n  updateTotal();\n})();\n<\/script>\n<\/div><fieldset id=\"field_34_105\" 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' >Does your organization offer before-school or after-school care?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_34_105'>\n\t\t\t<div class='gchoice gchoice_34_105_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_105' type='radio' value='Yes'  id='choice_34_105_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_105_0' id='label_34_105_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_34_105_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_105' type='radio' value='No'  id='choice_34_105_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_105_1' id='label_34_105_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_34_106\" 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' >Will children enrolled in before-school or after-school care participate in the Bookmobile visit?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_34_106'>\n\t\t\t<div class='gchoice gchoice_34_106_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_106' type='radio' value='Yes'  id='choice_34_106_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_106_0' id='label_34_106_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_34_106_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_106' type='radio' value='No'  id='choice_34_106_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_106_1' id='label_34_106_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_34_106_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_106' type='radio' value='Not sure yet'  id='choice_34_106_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_34_106_2' id='label_34_106_2' class='gform-field-label gform-field-label--type-inline'>Not sure yet<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_34_39\" class=\"gfield gfield--type-text gfield--input-type-text 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_34_39'>Outre l&#039;anglais, d&#039;autres langues sont-elles parl\u00e9es par les enfants qui visiteront le bibliobus&nbsp;? Bien que nous ne puissions garantir que nous serons en mesure d&#039;apporter des livres dans ces langues, cela nous aide \u00e0 mieux servir notre communaut\u00e9. <\/label><div class='ginput_container ginput_container_text'><input name='input_39' id='input_34_39' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_34_41\" 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_34_41'>Y a-t-il d&#039;autres renseignements que vous aimeriez que nous ayons&nbsp;?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_41' id='input_34_41' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_34_4\" 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_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_34_4'>Nom complet de l&#039;organisateur\/organisatrice&nbsp;:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_34_4' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_34_27\" 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_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_34_27'>Courriel de la personne-ressource de l&#039;organisateur\/organisatrice&nbsp;:<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_27' id='input_34_27' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_34_28\" 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_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_34_28'>Num\u00e9ro de t\u00e9l\u00e9phone de l&#039;organisateur\/organisatrice&nbsp;:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_28' id='input_34_28' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_34_47\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_34_47'>Quel est votre r\u00f4le&nbsp;?<\/label><div class='ginput_container ginput_container_text'><input name='input_47' id='input_34_47' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_34_6\" 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_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_34_6'>Lieu de l&#039;\u00e9v\u00e9nement du bibliobus&nbsp;:<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_34_6' type='text' value='' class='large'  aria-describedby=\"gfield_description_34_6\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_34_6'>Adresse civique o\u00f9 le bibliobus doit se stationner.<\/div><\/div><div id=\"field_34_49\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_34_49'>Ville :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_49' id='input_34_49' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_34_50\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ 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