{"id":4802,"date":"2023-10-18T11:54:36","date_gmt":"2023-10-18T16:54:36","guid":{"rendered":"https:\/\/www.missouriwestern.edu\/arc\/?page_id=4802"},"modified":"2026-03-03T16:20:50","modified_gmt":"2026-03-03T22:20:50","slug":"report-a-concern","status":"publish","type":"page","link":"https:\/\/www.missouriwestern.edu\/arc\/report-a-concern\/","title":{"rendered":"Report a Campus Accessibility Concern"},"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-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:104%;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_2_3 2_3 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:66.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:2.88%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:2.88%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1\"><p><span style=\"font-size: 14pt; font-family: helvetica, arial, sans-serif;\">Thank you for reporting your concerns about accessibility and inclusion at Missouri Western State University. All form submissions are completely anonymous, unless you choose to disclose your identity and provide contact information in order to receive a response.<\/span><\/p>\n<p><span style=\"font-size: 14pt; font-family: helvetica, arial, sans-serif;\">If you would prefer to schedule a meeting with ARC staff, you may do so through Google Calendar by clicking this link: <a href=\"https:\/\/calendar.app.google\/zJVQzRFB4iPZPb7U8\" target=\"_blank\" rel=\"noopener\">https:\/\/calendar.app.google\/zJVQzRFB4iPZPb7U8 (this link opens a new page)<\/a> Meetings set up through Google Calendar are not anonymous.<\/span><\/p>\n<\/div><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 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_25' style='display:none'>\n                        <div class='gform_heading'>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_25'  action='\/arc\/wp-json\/wp\/v2\/pages\/4802' data-formid='25' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_25' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_25_6\" class=\"gfield gfield--type-radio gfield--type-choice 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' >What is your role on campus<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_25_6'>\n\t\t\t<div class='gchoice gchoice_25_6_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='Student'  id='choice_25_6_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_6_0' id='label_25_6_0' class='gform-field-label gform-field-label--type-inline'>Student<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_6_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='Faculty'  id='choice_25_6_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_6_1' id='label_25_6_1' class='gform-field-label gform-field-label--type-inline'>Faculty<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_6_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='Staff'  id='choice_25_6_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_6_2' id='label_25_6_2' class='gform-field-label gform-field-label--type-inline'>Staff<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_6_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='Visitor'  id='choice_25_6_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_6_3' id='label_25_6_3' class='gform-field-label gform-field-label--type-inline'>Visitor<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_25_1\" class=\"gfield gfield--type-radio gfield--type-choice 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=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><legend class='gfield_label gform-field-label' >In which category does your concern fall?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_25_1'>\n\t\t\t<div class='gchoice gchoice_25_1_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_1' type='radio' value='Accessibility'  id='choice_25_1_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_1_0' id='label_25_1_0' class='gform-field-label gform-field-label--type-inline'>Accessibility<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_1_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_1' type='radio' value='Discrimination'  id='choice_25_1_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_1_1' id='label_25_1_1' class='gform-field-label gform-field-label--type-inline'>Discrimination<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_1_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_1' type='radio' value='gf_other_choice'  id='choice_25_1_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_1_2' id='label_25_1_2' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_25_1_other' class='gchoice_other_control' name='input_1_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_25_7\" class=\"gfield gfield--type-radio gfield--type-choice 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' >Identify the nature of the barrier<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_25_7'>\n\t\t\t<div class='gchoice gchoice_25_7_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='Access to buildings, facilities or grounds'  id='choice_25_7_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_7_0' id='label_25_7_0' class='gform-field-label gform-field-label--type-inline'>Access to buildings, facilities or grounds<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_7_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='Course materials and learning conditions'  id='choice_25_7_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_7_1' id='label_25_7_1' class='gform-field-label gform-field-label--type-inline'>Course materials and learning conditions<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_7_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='Web and IT applications and services'  id='choice_25_7_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_7_2' id='label_25_7_2' class='gform-field-label gform-field-label--type-inline'>Web and IT applications and services<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_7_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='gf_other_choice'  id='choice_25_7_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_7_3' id='label_25_7_3' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_25_7_other' class='gchoice_other_control' name='input_7_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_25_8\" class=\"gfield gfield--type-radio gfield--type-choice 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' >Please select what best describes the barrier(s) you experienced.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_25_8'>\n\t\t\t<div class='gchoice gchoice_25_8_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='Broken push plate'  id='choice_25_8_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_8_0' id='label_25_8_0' class='gform-field-label gform-field-label--type-inline'>Broken push plate<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_8_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='Elevator out of order'  id='choice_25_8_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_8_1' id='label_25_8_1' class='gform-field-label gform-field-label--type-inline'>Elevator out of order<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_8_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='Automatic door not functioning'  id='choice_25_8_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_8_2' id='label_25_8_2' class='gform-field-label gform-field-label--type-inline'>Automatic door not functioning<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_8_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='Blocked pathway'  id='choice_25_8_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_8_3' id='label_25_8_3' class='gform-field-label gform-field-label--type-inline'>Blocked pathway<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_8_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='Sidewalk Closure'  id='choice_25_8_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_8_4' id='label_25_8_4' class='gform-field-label gform-field-label--type-inline'>Sidewalk Closure<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_8_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gf_other_choice'  id='choice_25_8_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_8_5' id='label_25_8_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_25_8_other' class='gchoice_other_control' name='input_8_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_25_9\" class=\"gfield gfield--type-radio gfield--type-choice 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' >Please select what best describes the web\/IT barrier(s) you experienced.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_25_9'>\n\t\t\t<div class='gchoice gchoice_25_9_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Uncaptioned media'  id='choice_25_9_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_9_0' id='label_25_9_0' class='gform-field-label gform-field-label--type-inline'>Uncaptioned media<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_9_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Inaccessible document file'  id='choice_25_9_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_9_1' id='label_25_9_1' class='gform-field-label gform-field-label--type-inline'>Inaccessible document file<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_9_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Webpage images lack alt text'  id='choice_25_9_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_9_2' id='label_25_9_2' class='gform-field-label gform-field-label--type-inline'>Webpage images lack alt text<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_9_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Text color and background color are too similar'  id='choice_25_9_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_9_3' id='label_25_9_3' class='gform-field-label gform-field-label--type-inline'>Text color and background color are too similar<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_9_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='gf_other_choice'  id='choice_25_9_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_9_4' id='label_25_9_4' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_25_9_other' class='gchoice_other_control' name='input_9_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_25_10\" class=\"gfield gfield--type-radio gfield--type-choice 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' >Please select what best describes the course material\/learning conditions barrier you experienced.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_25_10'>\n\t\t\t<div class='gchoice gchoice_25_10_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='Lecture capture, video conferencing, video production and televised coursesn'  id='choice_25_10_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_10_0' id='label_25_10_0' class='gform-field-label gform-field-label--type-inline'>Lecture capture, video conferencing, video production and televised coursesn<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_10_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='Textbooks and course readers'  id='choice_25_10_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_10_1' id='label_25_10_1' class='gform-field-label gform-field-label--type-inline'>Textbooks and course readers<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_25_10_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='gf_other_choice'  id='choice_25_10_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_10_2' id='label_25_10_2' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_25_10_other' class='gchoice_other_control' name='input_10_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_25_2\" 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_25_2'>Please describe the barrier you encountered<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_2' id='input_25_2' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_25_4\" 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_25_4'>Do you have suggestions for addressing the concern(s) described above?<\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_25_4' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_25_5\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >I would like a reply to my concern and will provide my contact information.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_25_5'>\n\t\t\t<div class='gchoice gchoice_25_5_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_5' type='radio' value='Yes'  id='choice_25_5_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_5_0' id='label_25_5_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_25_5_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_5' type='radio' value='No'  id='choice_25_5_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_25_5_1' id='label_25_5_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_25_11\" class=\"gfield gfield--type-name gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' 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value=''   aria-required='false'     \/>\n                                                    <label for='input_25_11_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_25_13\" class=\"gfield gfield--type-email gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_25_13'>Email<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_13' id='input_25_13' type='email' value='' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_25_12\" class=\"gfield gfield--type-phone gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below 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