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We store your personal information on our cloud server as well as in paper form &amp; you can ask for it to be removed or updated at any stage by contacting info@ammonia.co.nz\\n&nbsp;\\nWe will not divulge any personal information to other parties what so ever unless legally obliged to do so.\\n&nbsp;\\nView our full Privacy Policy here: https:\\u002F\\u002Fwww.ammonia.co.nz\\u002Fpage\\u002Fprivacy-policy\",\"type\":\"control_text\"},null,null,{\"description\":\"\",\"name\":\"signature\",\"qid\":\"52\",\"subLabel\":\"\",\"text\":\"Signature\",\"type\":\"control_signature\"},{\"description\":\"\",\"name\":\"pleaseCheck\",\"qid\":\"53\",\"text\":\"Please check the boxes as appropriate\",\"type\":\"control_checkbox\"}]);}, 20); \n<\/script>\n\n      <\/div><div class=\"jfProgress progress-animate\" id=\"cardProgress\"><span class=\"jfProgressLine\"><span class=\"jfProgressLine-inner jsFeedbackProgressLine\" style=\"width:100%\"><\/span><\/span><span class=\"jfProgress-itemWrapperLine \"><\/span><span id=\"jsSubmitError\" class=\"jfProgress-formError\"><\/span><div class=\"jfProgress-itemWrapper \"><div class=\"jfProgress-itemCell\"><div class=\"jfProgress-item\" data-index=\"0\"><div class=\"jfProgress-itemCircle\"><span class=\"jfProgress-itemPulse\"><\/span><\/div><span class=\"jfProgress-itemLabel\">Question Label<\/span><span class=\"jfProgress-statusIcon\"><span class=\"iconSvg  icon_check \"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 326 326\" class=\"check-outer\"><g data-name=\"Layer 2\"><g data-name=\"Layer 1\"><path d=\"M163,0C73.12,0,0,73.12,0,163S73.12,326,163,326s163-73.12,163-163S252.88,0,163,0Z\"><\/path><path d=\"M237.88,108.5a13.49,13.49,0,0,0-19.08,0l-80.38,80.38-31.23-31.22a13.49,13.49,0,0,0-19.08,19.09l40.77,40.76a13.5,13.5,0,0,0,19.08,0l.34-.34h0l89.56-89.56a13.49,13.49,0,0,0,0-19.08Z\" class=\"check-inner\" style=\"fill:#fff\"><\/path><\/g><\/g><\/svg><\/span><\/span><\/div><\/div><\/div><div class=\"jfProgress-info\"><span class=\"jfProgress-infoContent\" id=\"cardProgressToggle\"><span class=\"jfProgress-infoContentText\"><span class=\"cardProgress-currentIndex\" id=\"cardProgress-currentIndex\">1 <\/span><span class=\"cardProgress-questionCount cardProgress-middleText\">of<\/span><span class=\"cardProgress-questionCount\" id=\"cardProgress-questionCount\"> 8<\/span><span class=\"cardProgress-seeAll\">See All<\/span><span class=\"cardProgress-goBack\">Go Back<\/span><\/span><\/span><\/div><div class=\"jfProgress-mobileNavigation jsMobileNavigation\" style=\"display:none\"><button type=\"button\" class=\"jfInput-button forPrev forMobileNav u-left jsMobilePrev noTranslate\" data-component=\"button\" aria-label=\"Previous\"><span class=\"iconSvg  arrow_left \"><svg version=\"1.1\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" x=\"0px\" y=\"0px\" viewBox=\"0 0 30.2 52.6\" style=\"enable-background:new 0 0 30.2 52.6;\" xml:space=\"preserve\"><g><g><path class=\"st0\" d=\"M23.7,51.7c1.5,1.4,3.8,1.3,5.2-0.2c1.3-1.4,1.3-3.6,0-5l-20-20l20-20 c1.5-1.4,1.7-3.7,0.3-5.2c-1.4-1.5-3.7-1.7-5.2-0.3c-0.1,0.1-0.2,0.2-0.3,0.3L1.1,23.8c-1.4,1.4-1.4,3.8,0,5.2c0,0,0,0,0,0 L23.7,51.7z\"><\/path><\/g><\/g><\/svg><\/span><\/button><button type=\"button\" class=\"jfInput-button forNext forMobileNav u-right jsMobileNext noTranslate\" data-component=\"button\" aria-label=\"Next\"><span class=\"iconSvg  arrow_left \"><svg version=\"1.1\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" x=\"0px\" y=\"0px\" viewBox=\"0 0 30.2 52.6\" style=\"enable-background:new 0 0 30.2 52.6;\" xml:space=\"preserve\"><g><g><path class=\"st0\" d=\"M23.7,51.7c1.5,1.4,3.8,1.3,5.2-0.2c1.3-1.4,1.3-3.6,0-5l-20-20l20-20 c1.5-1.4,1.7-3.7,0.3-5.2c-1.4-1.5-3.7-1.7-5.2-0.3c-0.1,0.1-0.2,0.2-0.3,0.3L1.1,23.8c-1.4,1.4-1.4,3.8,0,5.2c0,0,0,0,0,0 L23.7,51.7z\"><\/path><\/g><\/g><\/svg><\/span><\/button><button style=\"display:none\" type=\"button\" class=\"jfInput-button forSubmit forMobileNav form-submit-button u-center jsMobileSubmit\" data-component=\"button\" aria-label=\"Submit\">Submit<\/button><button class=\"jfInput-button u-left forBackToForm\" style=\"display:none\" aria-label=\"Back To Form\"><\/button><\/div><\/div><div class=\"jfForm-wrapper\"><div class=\"jfForm-backgroundContainer\"><\/div><div class=\"jfForm-backgroundUnderlay\"><\/div><div class=\"jfForm-backgroundOverlay\"><\/div><div class=\"jfForm-background\"><div class=\"jfForm-background-mask\"><\/div><\/div><div class=\"jfWelcome-wrapper\" role=\"banner\"><div class=\"jfWelcome\"><div class=\"jfWelcome-imageWrapper\"><div class=\"jfWelcome-image\"><span class=\"iconSvg iconSvgFill https:\/\/icons.jotfor.ms\/cardforms\/assets\/icons\/icon-sets\/default\/business-bank.svg \"><svg class=\"iconSvgFill\" stroke=\"none\"  version=\"1.0\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" x=\"0px\" y=\"0px\" viewBox=\"0 0 64 64\" enable-background=\"new 0 0 64 64\" xml:space=\"preserve\"><path d=\"M60,52h-6V24h6c1.814,0,3.4-1.221,3.865-2.973c0.467-1.754-0.307-3.6-1.881-4.5l-28-16 C33.369,0.176,32.684,0,32,0s-1.369,0.176-1.984,0.527l-28,16c-1.574,0.9-2.348,2.746-1.881,4.5C0.6,22.779,2.186,24,4,24h6v28H4 c-2.209,0-4,1.791-4,4v8h64v-8C64,53.791,62.209,52,60,52z M6,20c-1.219,0-0.551-0.828-0.025-1.129 C6.436,18.607,26.051,7.4,30.916,4.619c0.689-0.395,1.449-0.41,2.094-0.043c4.721,2.697,24.404,13.943,25,14.285 C58.688,19.25,59.312,20,58,20S7.219,20,6,20z M50,24v28h-4V24H50z M42,24v28h-4V24H42z M34,24v28h-4V24H34z M26,24v28h-4V24H26z M18,24v28h-4V24H18z M60,60H4v-2c0-1.105,0.895-2,2-2h52c1.105,0,2,0.895,2,2V60z\"><\/path><\/svg><\/span><\/div><\/div><div id=\"header_welcomePage\" class=\"jfWelcome-header form-header\" data-component=\"header\" style=\"opacity:1\">Student Training Registration Form<\/div><div id=\"subHeader_welcomePage\" class=\"jfWelcome-description form-subHeader\">Fill out the form carefully for registration<\/div><div class=\"jfWelcome-sectionInfo\"><span class=\"jfWelcome-sectionInfo-questionCount\"><\/span><span class=\"jfWelcome-sectionInfo-text\"><\/span><\/div><div class=\"jfWelcome-buttonWrapper\"><button class=\"jfWelcome-button\" id=\"jfCard-welcome-previous\" style=\"display:none\" aria-label=\"Previous\"><\/button><\/div><div class=\"jfWelcome-buttonWrapper\"><button class=\"jfWelcome-button\" id=\"jfCard-welcome-start\" style=\"display:inline\" aria-label=\"START\">START<\/button><\/div><\/div><\/div><div class=\"jfForm-logo\" role=\"banner\"><span class=\"iconSvg iconSvgFill https:\/\/icons.jotfor.ms\/cardforms\/assets\/icons\/icon-sets\/default\/business-bank.svg \"><svg class=\"iconSvgFill\" stroke=\"none\"  version=\"1.0\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" x=\"0px\" y=\"0px\" viewBox=\"0 0 64 64\" enable-background=\"new 0 0 64 64\" xml:space=\"preserve\"><path d=\"M60,52h-6V24h6c1.814,0,3.4-1.221,3.865-2.973c0.467-1.754-0.307-3.6-1.881-4.5l-28-16 C33.369,0.176,32.684,0,32,0s-1.369,0.176-1.984,0.527l-28,16c-1.574,0.9-2.348,2.746-1.881,4.5C0.6,22.779,2.186,24,4,24h6v28H4 c-2.209,0-4,1.791-4,4v8h64v-8C64,53.791,62.209,52,60,52z M6,20c-1.219,0-0.551-0.828-0.025-1.129 C6.436,18.607,26.051,7.4,30.916,4.619c0.689-0.395,1.449-0.41,2.094-0.043c4.721,2.697,24.404,13.943,25,14.285 C58.688,19.25,59.312,20,58,20S7.219,20,6,20z M50,24v28h-4V24H50z M42,24v28h-4V24H42z M34,24v28h-4V24H34z M26,24v28h-4V24H26z M18,24v28h-4V24H18z M60,60H4v-2c0-1.105,0.895-2,2-2h52c1.105,0,2,0.895,2,2V60z\"><\/path><\/svg><\/span><\/div><form role=\"main\" class=\"jotform-form\" id=\"92178426315863\" name=\"form_92178426315863\" action=\"https:\/\/submit.jotform.co\/submit\/92178426315863\/\" method=\"post\"><input type=\"hidden\" name=\"formID\" value=\"92178426315863\"\/><ul class=\"jfForm-all form-section page-section form-all\" id=\"cardAnimationWrapper\"><li class=\"form-line\" data-type=\"control_datetime\" id=\"id_47\"><div id=\"cid_47\" class=\"jfCard-wrapper\"><div class=\"jfCard\" data-type=\"control_datetime\"><div class=\"jfCard-index\"><div>1<\/div><\/div><div class=\"jfCard-question\"><div class=\"jfQuestion-fullscreen isHidden\"><\/div><label for=\"lite_mode_47\" class=\"jfQuestion-label isCenterAlign\" id=\"label_47\"><span class=\"jsQuestionLabelContainer\">Today's Date<\/span><span class=\"jfRequiredStar\">* <span class=\"jfRequiredStar-message\">This field is required<\/span><\/span><\/label><span class=\"jfQuestion-description\" id=\"input_47_description\"><\/span><div class=\"jfCard-mobileError jsMobileErrorWrapper\"><\/div><div class=\"jfQuestion-fields isCompoundField jfQuestion-fields-contentVisible\" data-wrapper-react=\"true\"><div class=\"jfField isFilled\" data-wrapper-react=\"true\" data-type=\"liteDate\"><input type=\"date\" id=\"input_47\" class=\"form-textbox jfInput-input jfCardDateInput\" value=\"\" data-age=\"\" max=\"2100-12-30\"\/><span style=\"display:initial\" class=\"jfField-svgWrapper forDate\"><svg data-name=\"Layer 1\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 83.65 83.47\"><path d=\"M17.08,68.74c0-.43,0-0.79,0-1.15q0-16.83,0-33.66a1.23,1.23,0,0,0-.95-1.45,2,2,0,0,1-1.37-2c0-2.23,0-4.45,0-6.68a2.15,2.15,0,0,1,2.11-2.27c2.07-.08,4.15,0,6.22,0a0.59,0.59,0,0,1,.64.75c0,1,0,2,0,3.07a0.63,0.63,0,0,0,.74.76c2.53,0,5.05,0,7.58,0a0.66,0.66,0,0,0,.77-0.82c0-1,0-1.93,0-2.89a0.69,0.69,0,0,1,.8-0.88q8.21,0,16.42,0a0.69,0.69,0,0,1,.8.88c0,1,0,1.93,0,2.89a0.66,0.66,0,0,0,.77.82q3.79,0,7.58,0a0.63,0.63,0,0,0,.73-0.76c0-1,0-2,0-3.07a0.62,0.62,0,0,1,.74-0.75c2,0,4,0,6,0a2.22,2.22,0,0,1,2.28,2.39c0,2.17,0,4.33,0,6.5a2.06,2.06,0,0,1-1.46,2.15,1.12,1.12,0,0,0-.86,1.33q0,16.88,0,33.75v1.14H17.08Zm24.77-4.37H61c1.2,0,1.23,0,1.23-1.2,0-9.77,0-19.54,0-29.31a1,1,0,0,0-1.16-1.17q-19.21,0-38.42,0c-1.19,0-1.19,0-1.19,1.2q0,14.57,0,29.13c0,1.32,0,1.33,1.38,1.33h19Z\"><\/path><path d=\"M26.14,23.64V14.77h4.27v8.86H26.14Z\"><\/path><path d=\"M53.26,14.73h4.2v8.9h-4.2v-8.9Z\"><\/path><path d=\"M57.55,59.73H53.24V55.36c1.33,0,2.64,0,3.95,0a0.66,0.66,0,0,1,.34.5C57.56,57.14,57.55,58.4,57.55,59.73Z\"><\/path><path d=\"M48.52,59.73H44.21V55.35c1.3,0,2.58,0,3.86,0a0.69,0.69,0,0,1,.43.51C48.54,57.14,48.52,58.4,48.52,59.73Z\"><\/path><path d=\"M35.18,59.73V55.41h4.23v4.32H35.18Z\"><\/path><path d=\"M30.47,59.74H26.11c0-1.34,0-2.65,0-4a0.7,0.7,0,0,1,.52-0.41c1.08,0,2.17,0,3.25,0a0.81,0.81,0,0,1,.54.57C30.5,57.17,30.47,58.4,30.47,59.74Z\"><\/path><path d=\"M53.22,50.69V46.33c1.34,0,2.65,0,4,0a0.65,0.65,0,0,1,.35.5c0,1.26,0,2.52,0,3.84H53.22Z\"><\/path><path d=\"M48.44,50.71H44.17c0-1.35,0-2.69,0-4a0.65,0.65,0,0,1,.5-0.34c1.23,0,2.45,0,3.76,0v4.38Z\"><\/path><path d=\"M39.5,50.71H35.13c0-1.34,0-2.65,0-4a0.7,0.7,0,0,1,.52-0.41c1.08,0,2.17,0,3.25,0a0.81,0.81,0,0,1,.54.57C39.52,48.15,39.5,49.38,39.5,50.71Z\"><\/path><path d=\"M30.47,50.71H26.11c0-1.34,0-2.65,0-4a0.7,0.7,0,0,1,.52-0.41c1.08,0,2.17,0,3.25,0a0.81,0.81,0,0,1,.55.57C30.5,48.14,30.47,49.38,30.47,50.71Z\"><\/path><path d=\"M53.26,37.34h4.2v4.34h-4.2V37.34Z\"><\/path><path d=\"M44.24,37.34h4.2v4.34h-4.2V37.34Z\"><\/path><path d=\"M39.5,41.69H35.13c0-1.33,0-2.64,0-3.95a0.61,0.61,0,0,1,.43-0.42c1.14,0,2.29,0,3.43,0a0.75,0.75,0,0,1,.47.56C39.52,39.12,39.5,40.35,39.5,41.69Z\"><\/path><path d=\"M30.39,41.68H26.18V37.36h4.21v4.32Z\"><\/path><\/svg><\/span><label class=\"jfField-sublabel\" for=\"input_47\" id=\"sublabel_input_47\">Date<\/label><\/div><div style=\"display:none\"><div class=\"jfField  isHidden cf-valid-hidden\" data-type=\"year\"><input type=\"tel\" id=\"year_47\" name=\"q47_todaysDate[year]\" class=\"form-textbox validate[required, limitDate] jfInput-input hasSublabel\" size=\"4\" value=\"\" maxLength=\"4\" data-maxlength=\"4\" data-component=\"year\" required=\"\" aria-required=\"true\" aria-describedby=\"year_47_description\"\/><label class=\"jfField-sublabel\" for=\"year_47\" id=\"sublabel_47_year\">Year<\/label><\/div><div class=\"jfField  isHidden cf-valid-hidden\" data-type=\"month\"><input type=\"tel\" id=\"month_47\" name=\"q47_todaysDate[month]\" class=\"form-textbox validate[required, limitDate] jfInput-input hasSublabel\" size=\"2\" value=\"\" maxLength=\"2\" data-maxlength=\"2\" data-component=\"month\" required=\"\" aria-required=\"true\" aria-describedby=\"month_47_description\"\/><label class=\"jfField-sublabel\" for=\"month_47\" id=\"sublabel_47_month\">Month<\/label><\/div><div class=\"jfField  isHidden cf-valid-hidden\" data-type=\"day\"><input type=\"tel\" id=\"day_47\" name=\"q47_todaysDate[day]\" class=\"form-textbox validate[required, limitDate] jfInput-input hasSublabel\" size=\"2\" value=\"\" maxLength=\"2\" data-maxlength=\"2\" data-component=\"day\" required=\"\" aria-required=\"true\" aria-describedby=\"day_47_description\"\/><label class=\"jfField-sublabel\" for=\"day_47\" id=\"sublabel_47_day\">Day<\/label><\/div><\/div><div class=\"jfField  isHidden cf-valid-hidden\"><input type=\"text\" id=\"lite_mode_47\" class=\"form-textbox validate[required, limitDate, validateLiteDate] jfInput-input hasSublabel\" size=\"12\" value=\"\" maxLength=\"12\" data-maxlength=\"12\" data-format=\"yyyymmdd\" data-seperator=\"-\" data-age=\"\" required=\"\" aria-required=\"true\" aria-describedby=\"lite_mode_47_description\"\/><label class=\"jfField-sublabel\" for=\"lite_mode_47\" id=\"sublabel_47_litemode\">Date<\/label><\/div><img alt=\"Pick a Date\" id=\"input_47_pick\" style=\"display:none;vertical-align:middle\" data-component=\"datetime\"\/><div class=\"jfCalendar-wrapper\"><div id=\"calendar-container-47\" class=\"jfCalendar-container\"><\/div><\/div><\/div><\/div><div class=\"jfCard-actions\"><button style=\"display:none\" type=\"button\" class=\"jfInput-button forPrev u-left\" data-component=\"button\" aria-label=\"Previous\">Previous<\/button><button style=\"display:block\" type=\"button\" class=\"jfInput-button forNext u-right\" data-component=\"button\" aria-label=\"Next\">Next<\/button><button style=\"display:none\" type=\"submit\" class=\"jfInput-button forSubmit form-submit-button u-right\" data-component=\"button\" aria-label=\"Submit\">Submit<\/button><div class=\"cf\"><div class=\"jfCard-actionsNotification\"><div class=\"jfPressEnter isHidden\">Press<br\/>Enter<\/div><\/div><\/div><div class=\"jfCard-disableSubmitError\"><\/div><\/div><\/div><\/div><\/li><li class=\"form-line\" data-type=\"control_radio\" id=\"id_48\"><div id=\"cid_48\" class=\"jfCard-wrapper\"><div class=\"jfCard\" data-type=\"control_radio\"><div class=\"jfCard-index\"><div>2<\/div><\/div><div class=\"jfCard-question\"><div class=\"jfQuestion-fullscreen isHidden\"><\/div><label for=\"input_48\" class=\"jfQuestion-label isCenterAlign\" id=\"label_48\"><span class=\"jsQuestionLabelContainer\">Course<\/span><span class=\"jfRequiredStar\">* <span class=\"jfRequiredStar-message\">This field is required<\/span><\/span><\/label><span class=\"jfQuestion-description\" id=\"input_48_description\"><\/span><div class=\"jfCard-mobileError jsMobileErrorWrapper\"><\/div><div class=\"jfQuestion-fields form-multiple-column\" data-columncount=\"2\" data-component=\"radio\"><div class=\"jfField form-radio-item\"><label class=\"jfRadio withoutImage\"><input type=\"radio\" class=\"jfRadio-input form-radio validate[required]\" name=\"q48_course\" value=\"Ammonia Awareness One Day\" id=\"input_48_0\" required=\"\"\/><div class=\"jfRadio-label\"><span class=\"jfRadio-customInput\"><span class=\"jfRadio-customInputIcon\"><\/span><\/span><img class=\"jfRadio-visual\" alt=\"Radio\"\/><span class=\"jfRadio-labelText\">Ammonia Awareness One Day<\/span><\/div><\/label><\/div><div class=\"jfField form-radio-item\"><label class=\"jfRadio withoutImage\"><input type=\"radio\" class=\"jfRadio-input form-radio validate[required]\" name=\"q48_course\" value=\"Introduction to Ammonia\" id=\"input_48_1\" required=\"\"\/><div class=\"jfRadio-label\"><span class=\"jfRadio-customInput\"><span class=\"jfRadio-customInputIcon\"><\/span><\/span><img class=\"jfRadio-visual\" alt=\"Radio\"\/><span class=\"jfRadio-labelText\">Introduction to Ammonia<\/span><\/div><\/label><\/div><div class=\"jfField form-radio-item\"><label class=\"jfRadio withoutImage\"><input type=\"radio\" class=\"jfRadio-input form-radio validate[required]\" name=\"q48_course\" value=\"Ammonia Technician\" id=\"input_48_2\" required=\"\"\/><div class=\"jfRadio-label\"><span class=\"jfRadio-customInput\"><span class=\"jfRadio-customInputIcon\"><\/span><\/span><img class=\"jfRadio-visual\" alt=\"Radio\"\/><span class=\"jfRadio-labelText\">Ammonia Technician<\/span><\/div><\/label><\/div><div class=\"jfField form-radio-item\"><label class=\"jfRadio withoutImage\"><input type=\"radio\" class=\"jfRadio-input form-radio validate[required]\" name=\"q48_course\" value=\"Ammonia Operator\" id=\"input_48_3\" required=\"\"\/><div class=\"jfRadio-label\"><span class=\"jfRadio-customInput\"><span class=\"jfRadio-customInputIcon\"><\/span><\/span><img class=\"jfRadio-visual\" alt=\"Radio\"\/><span class=\"jfRadio-labelText\">Ammonia Operator<\/span><\/div><\/label><\/div><div class=\"jfField jfField-lastRowItem form-radio-item\"><label class=\"jfRadio withoutImage\"><input type=\"radio\" class=\"jfRadio-input form-radio validate[required]\" name=\"q48_course\" value=\"Emergency Management\" id=\"input_48_4\" required=\"\"\/><div class=\"jfRadio-label\"><span class=\"jfRadio-customInput\"><span class=\"jfRadio-customInputIcon\"><\/span><\/span><img class=\"jfRadio-visual\" alt=\"Radio\"\/><span class=\"jfRadio-labelText\">Emergency Management<\/span><\/div><\/label><\/div><\/div><\/div><div class=\"jfCard-actions\"><button style=\"display:block\" type=\"button\" class=\"jfInput-button forPrev u-left\" data-component=\"button\" aria-label=\"Previous\">Previous<\/button><button style=\"display:block\" type=\"button\" class=\"jfInput-button forNext u-right\" data-component=\"button\" aria-label=\"Next\">Next<\/button><button style=\"display:none\" type=\"submit\" class=\"jfInput-button forSubmit form-submit-button u-right\" data-component=\"button\" aria-label=\"Submit\">Submit<\/button><div class=\"cf\"><div class=\"jfCard-actionsNotification\"><div class=\"jfPressEnter isHidden\">Press<br\/>Enter<\/div><\/div><\/div><div class=\"jfCard-disableSubmitError\"><\/div><\/div><\/div><\/div><\/li><li class=\"form-line\" data-type=\"control_fullname\" id=\"id_4\" data-compound-hint=\"\"><div id=\"cid_4\" class=\"jfCard-wrapper\"><div class=\"jfCard\" data-type=\"control_fullname\"><div class=\"jfCard-index\"><div>3<\/div><\/div><div class=\"jfCard-question\"><div class=\"jfQuestion-fullscreen isHidden\"><\/div><label for=\"first_4\" class=\"jfQuestion-label isCenterAlign\" id=\"label_4\"><span class=\"jsQuestionLabelContainer\">Student Name<\/span><span class=\"jfRequiredStar\">* <span class=\"jfRequiredStar-message\">This field is required<\/span><\/span><\/label><span class=\"jfQuestion-description\" id=\"input_4_description\"><\/span><div class=\"jfCard-mobileError jsMobileErrorWrapper\"><\/div><div class=\"jfQuestion-fields\" data-wrapper-react=\"true\"><div class=\"jfField\" data-type=\"first\"><input type=\"text\" id=\"first_4\" name=\"q4_studentName[first]\" class=\"form-textbox validate[required] forFullname jfInput-input hasSublabel\" autoComplete=\"fname\" size=\"10\" value=\"\" data-component=\"first\" required=\"\" aria-required=\"true\" aria-describedby=\"first_4_description\" aria-labelledby=\"label_4 sublabel_4_first\"\/><label class=\"jfField-sublabel\" for=\"first_4\" id=\"sublabel_4_first\">First Name<\/label><\/div><div class=\"jfField\" data-type=\"middle\"><input type=\"text\" id=\"middle_4\" name=\"q4_studentName[middle]\" class=\"form-textbox forFullname jfInput-input hasSublabel\" autoComplete=\"mname\" size=\"10\" value=\"\" data-component=\"middle\" required=\"\" aria-required=\"true\" aria-describedby=\"middle_4_description\" aria-labelledby=\"label_4 sublabel_4_middle\"\/><label class=\"jfField-sublabel\" for=\"middle_4\" id=\"sublabel_4_middle\">Middle Name<\/label><\/div><div class=\"jfField\" data-type=\"last\"><input type=\"text\" id=\"last_4\" name=\"q4_studentName[last]\" class=\"form-textbox validate[required] forFullname jfInput-input hasSublabel\" autoComplete=\"lname\" size=\"15\" value=\"\" data-component=\"last\" required=\"\" aria-required=\"true\" aria-describedby=\"last_4_description\" aria-labelledby=\"label_4 sublabel_4_last\"\/><label class=\"jfField-sublabel\" for=\"last_4\" id=\"sublabel_4_last\">Last Name<\/label><\/div><\/div><\/div><div class=\"jfCard-actions\"><button style=\"display:block\" type=\"button\" class=\"jfInput-button forPrev u-left\" data-component=\"button\" aria-label=\"Previous\">Previous<\/button><button style=\"display:block\" type=\"button\" class=\"jfInput-button forNext u-right\" data-component=\"button\" aria-label=\"Next\">Next<\/button><button style=\"display:none\" type=\"submit\" class=\"jfInput-button forSubmit form-submit-button u-right\" data-component=\"button\" aria-label=\"Submit\">Submit<\/button><div class=\"cf\"><div class=\"jfCard-actionsNotification\"><div class=\"jfPressEnter isHidden\">Press<br\/>Enter<\/div><\/div><\/div><div class=\"jfCard-disableSubmitError\"><\/div><\/div><\/div><\/div><\/li><li class=\"form-line\" data-type=\"control_email\" id=\"id_6\"><div id=\"cid_6\" class=\"jfCard-wrapper\"><div class=\"jfCard\" data-type=\"control_email\"><div class=\"jfCard-index\"><div>4<\/div><\/div><div class=\"jfCard-question\"><div class=\"jfQuestion-fullscreen isHidden\"><\/div><label for=\"input_6\" class=\"jfQuestion-label isCenterAlign\" id=\"label_6\"><span class=\"jsQuestionLabelContainer\">Student E-mail<\/span><span class=\"jfRequiredStar\">* <span class=\"jfRequiredStar-message\">This field is required<\/span><\/span><\/label><span class=\"jfQuestion-description\" id=\"input_6_description\"><\/span><div class=\"jfCard-mobileError jsMobileErrorWrapper\"><\/div><div class=\"jfQuestion-fields questionMode\"><div class=\"jfField\" data-type=\"email\"><input type=\"email\" id=\"input_6\" name=\"q6_studentEmail6\" class=\"form-textbox validate[required, Email] forEmail jfInput-input\" autoComplete=\"email\" size=\"30\" value=\"\" placeholder=\"ex: myname@example.com\" data-component=\"email\" required=\"\" aria-required=\"true\" aria-describedby=\"input_6_description\"\/><label class=\"jfField-sublabel\" for=\"input_6\"><\/label><div class=\"jfCardTooltip js-tooltipContainer\"><div class=\"js-tooltipMessageContainer-info\"><\/div><div class=\"js-tooltipMessageContainer-error\"><\/div><div class=\"jfCardTooltip-close js-tooltipCloseButton\"><span class=\"iconSvg  icon_error \"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 326 326\"><g data-name=\"Layer 2\"><g data-name=\"Layer 1\"><path class=\"fail-outer\" d=\"M163,0C73.12,0,0,73.12,0,163S73.12,326,163,326s163-73.12,163-163S252.88,0,163,0Z\"><\/path><path class=\"fail-inner\" d=\"M227.6,98.4a14.75,14.75,0,0,0-20.86,0L163,142.14,119.26,98.4A14.75,14.75,0,1,0,98.4,119.26L142.14,163,98.4,206.74a14.75,14.75,0,1,0,20.86,20.86L163,183.86l43.74,43.74a14.75,14.75,0,1,0,20.86-20.86L183.86,163l43.74-43.74A14.75,14.75,0,0,0,227.6,98.4Z\"><\/path><\/g><\/g><\/svg><\/span><\/div><\/div><\/div><div class=\"jfEmailVerify-loading\"><span class=\"loadingDot\"><\/span><span class=\"loadingDot isD2\"><\/span><span class=\"loadingDot isD3\"><\/span><\/div><\/div><\/div><div class=\"jfCard-actions\"><button style=\"display:block\" type=\"button\" class=\"jfInput-button forPrev u-left\" data-component=\"button\" aria-label=\"Previous\">Previous<\/button><button style=\"display:block\" type=\"button\" class=\"jfInput-button forNext u-right\" data-component=\"button\" aria-label=\"Next\">Next<\/button><button style=\"display:none\" type=\"submit\" class=\"jfInput-button forSubmit form-submit-button u-right\" data-component=\"button\" aria-label=\"Submit\">Submit<\/button><div class=\"cf\"><div class=\"jfCard-actionsNotification\"><div class=\"jfPressEnter isHidden\">Press<br\/>Enter<\/div><\/div><\/div><div class=\"jfCard-disableSubmitError\"><\/div><\/div><\/div><\/div><\/li><li class=\"form-line\" data-type=\"control_phone\" id=\"id_27\" data-compound-hint=\"\"><div id=\"cid_27\" class=\"jfCard-wrapper\"><div class=\"jfCard\" data-type=\"control_phone\"><div class=\"jfCard-index\"><div>5<\/div><\/div><div class=\"jfCard-question\"><div class=\"jfQuestion-fullscreen isHidden\"><\/div><label for=\"input_27_area\" class=\"jfQuestion-label isCenterAlign\" id=\"label_27\"><span class=\"jsQuestionLabelContainer\">Mobile Number<\/span><span class=\"jfRequiredStar\">* <span class=\"jfRequiredStar-message\">This field is required<\/span><\/span><\/label><span class=\"jfQuestion-description\" id=\"input_27_description\"><\/span><div class=\"jfCard-mobileError jsMobileErrorWrapper\"><\/div><div class=\"jfQuestion-fields\" data-wrapper-react=\"true\"><div class=\"jfField\" data-type=\"areaCode\"><input type=\"tel\" id=\"input_27_area\" name=\"q27_mobileNumber[area]\" class=\"form-textbox validate[required] forPhone jfInput-input hasSublabel\" autoComplete=\"tel-area-code\" size=\"6\" value=\"\" data-component=\"areaCode\" required=\"\" aria-required=\"true\" aria-describedby=\"input_27_area_description\" aria-labelledby=\"label_27 sublabel_27_area\"\/><label class=\"jfField-sublabel\" for=\"input_27_area\" id=\"sublabel_27_area\">Area Code<\/label><\/div><div class=\"jfField\" data-type=\"phone\"><input type=\"tel\" id=\"input_27_phone\" name=\"q27_mobileNumber[phone]\" class=\"form-textbox validate[required] forPhone jfInput-input hasSublabel\" autoComplete=\"tel-local\" size=\"12\" value=\"\" data-component=\"phone\" required=\"\" aria-required=\"true\" aria-describedby=\"input_27_phone_description\" aria-labelledby=\"label_27 sublabel_27_phone\"\/><label class=\"jfField-sublabel\" for=\"input_27_phone\" id=\"sublabel_27_phone\">Phone Number<\/label><\/div><\/div><\/div><div class=\"jfCard-actions\"><button style=\"display:block\" type=\"button\" class=\"jfInput-button forPrev u-left\" data-component=\"button\" aria-label=\"Previous\">Previous<\/button><button style=\"display:block\" type=\"button\" class=\"jfInput-button forNext u-right\" data-component=\"button\" aria-label=\"Next\">Next<\/button><button style=\"display:none\" type=\"submit\" class=\"jfInput-button forSubmit form-submit-button u-right\" data-component=\"button\" aria-label=\"Submit\">Submit<\/button><div class=\"cf\"><div class=\"jfCard-actionsNotification\"><div class=\"jfPressEnter isHidden\">Press<br\/>Enter<\/div><\/div><\/div><div class=\"jfCard-disableSubmitError\"><\/div><\/div><\/div><\/div><\/li><li class=\"form-line\" data-type=\"control_text\" id=\"id_49\"><div id=\"cid_49\" class=\"jfCard-wrapper\"><div class=\"jfCard\" data-type=\"control_text\"><div class=\"jfCard-index\"><div>6<\/div><\/div><div class=\"jfCard-question\"><div class=\"jfQuestion-fullscreen isHidden\"><\/div><div class=\"jfCard-mobileError jsMobileErrorWrapper\"><\/div><div class=\"jfQuestion-fields\"><div class=\"jfField\"><div id=\"text_49\" class=\"form-html\" data-component=\"text\"><p>Gauge refrigeration Management Ltd is bound by the New Zealand Privacy Act 1993. Not only are we obliged but we respect your rights to privacy &amp; therefore will do our best to protect your information. We store your personal information on our cloud server as well as in paper form &amp; you can ask for it to be removed or updated at any stage by contacting info@ammonia.co.nz<\/p>\n<p> <\/p>\n<p>We will not divulge any personal information to other parties what so ever unless legally obliged to do so.<\/p>\n<p> <\/p>\n<p>View our full Privacy Policy here: <a href=\"https:\/\/www.ammonia.co.nz\/page\/privacy-policy\" target=\"_blank\" rel=\"nofollow\">https:\/\/www.ammonia.co.nz\/page\/privacy-policy<\/a><\/p><\/div><\/div><\/div><\/div><div class=\"jfCard-actions\"><button style=\"display:block\" type=\"button\" class=\"jfInput-button forPrev u-left\" data-component=\"button\" aria-label=\"Previous\">Previous<\/button><button style=\"display:block\" type=\"button\" class=\"jfInput-button forNext u-right\" data-component=\"button\" aria-label=\"Next\">Next<\/button><button style=\"display:none\" type=\"submit\" class=\"jfInput-button forSubmit form-submit-button u-right\" data-component=\"button\" aria-label=\"Submit\">Submit<\/button><div class=\"cf\"><div class=\"jfCard-actionsNotification\"><div class=\"jfPressEnter isHidden\">Press<br\/>Enter<\/div><\/div><\/div><div class=\"jfCard-disableSubmitError\"><\/div><\/div><\/div><\/div><\/li><li class=\"form-line\" data-type=\"control_checkbox\" id=\"id_53\"><div id=\"cid_53\" class=\"jfCard-wrapper\"><div class=\"jfCard\" data-type=\"control_checkbox\"><div class=\"jfCard-index\"><div>7<\/div><\/div><div class=\"jfCard-question\"><div class=\"jfQuestion-fullscreen isHidden\"><\/div><label for=\"input_53_0\" class=\"jfQuestion-label isCenterAlign\" id=\"label_53\"><span class=\"jsQuestionLabelContainer\">Please check the boxes as appropriate<\/span><span class=\"jfRequiredStar\">* <span class=\"jfRequiredStar-message\">This field is required<\/span><\/span><\/label><span class=\"jfQuestion-description\" id=\"input_53_description\"><\/span><div class=\"jfCard-mobileError jsMobileErrorWrapper\"><\/div><div class=\"jfQuestion-fields form-single-column\" data-component=\"checkbox\"><div class=\"jfField form-checkbox-item\"><label class=\"jfCheckbox withoutImage\"><input type=\"checkbox\" class=\"jfCheckbox-input form-checkbox validate[required]\" name=\"q53_pleaseCheck[]\" value=\"I consent to the storage of evaluation results for future assessment and moderation purposes only.\" id=\"input_53_0\" required=\"\"\/><div class=\"jfCheckbox-label\"><span class=\"jfCheckbox-customInput\"><span class=\"jfCheckbox-customInputIcon\"><\/span><\/span><img class=\"jfCheckbox-visual\" alt=\"Checkbox\"\/><span class=\"jfCheckbox-labelText\">I consent to the storage of evaluation results for future assessment and moderation purposes only.<\/span><\/div><\/label><\/div><div class=\"jfField form-checkbox-item\"><label class=\"jfCheckbox withoutImage\"><input type=\"checkbox\" class=\"jfCheckbox-input form-checkbox validate[required]\" name=\"q53_pleaseCheck[]\" value=\"I consent to the use of any testimonials, images and media recorded during the course for use on social media or marketing material\" id=\"input_53_1\" required=\"\"\/><div class=\"jfCheckbox-label\"><span class=\"jfCheckbox-customInput\"><span class=\"jfCheckbox-customInputIcon\"><\/span><\/span><img class=\"jfCheckbox-visual\" alt=\"Checkbox\"\/><span class=\"jfCheckbox-labelText\">I consent to the use of any testimonials, images and media recorded during the course for use on social media or marketing material<\/span><\/div><\/label><\/div><div class=\"jfField form-checkbox-item\"><label class=\"jfCheckbox withoutImage\"><input type=\"checkbox\" class=\"jfCheckbox-input form-checkbox validate[required]\" name=\"q53_pleaseCheck[]\" value=\"I am medically fit &amp; comfortable in wearing breathing apparatus &amp; participating in physical activities.\" id=\"input_53_2\" required=\"\"\/><div class=\"jfCheckbox-label\"><span class=\"jfCheckbox-customInput\"><span class=\"jfCheckbox-customInputIcon\"><\/span><\/span><img class=\"jfCheckbox-visual\" alt=\"Checkbox\"\/><span class=\"jfCheckbox-labelText\">I am medically fit &amp; comfortable in wearing breathing apparatus &amp; participating in physical activities.<\/span><\/div><\/label><\/div><\/div><\/div><div class=\"jfCard-actions\"><button style=\"display:block\" type=\"button\" class=\"jfInput-button forPrev u-left\" data-component=\"button\" aria-label=\"Previous\">Previous<\/button><button style=\"display:block\" type=\"button\" class=\"jfInput-button forNext u-right\" data-component=\"button\" aria-label=\"Next\">Next<\/button><button style=\"display:none\" type=\"submit\" class=\"jfInput-button forSubmit form-submit-button u-right\" data-component=\"button\" aria-label=\"Submit\">Submit<\/button><div class=\"cf\"><div class=\"jfCard-actionsNotification\"><div class=\"jfPressEnter isHidden\">Press<br\/>Enter<\/div><\/div><\/div><div class=\"jfCard-disableSubmitError\"><\/div><\/div><\/div><\/div><\/li><li class=\"form-line\" data-type=\"control_signature\" id=\"id_52\"><div id=\"cid_52\" class=\"jfCard-wrapper\"><div class=\"jfCard\" data-type=\"control_signature\"><div class=\"jfCard-index\"><div>8<\/div><\/div><div class=\"jfCard-question\" data-widget-id=\"528c8b8186659c5616000004\"><div class=\"jfQuestion-fullscreen isHidden\"><\/div><label for=\"input_52\" class=\"jfQuestion-label isCenterAlign\" id=\"label_52\"><span class=\"jsQuestionLabelContainer\">Signature<\/span><span class=\"jfRequiredStar\">* <span class=\"jfRequiredStar-message\">This field is required<\/span><\/span><\/label><span class=\"jfQuestion-description\" id=\"input_52_description\"><\/span><div class=\"jfCard-mobileError jsMobileErrorWrapper\"><\/div><div class=\"jfQuestion-fields\" data-wrapper-react=\"true\"><div class=\"jfField\"><div id=\"signature_pad_52\" class=\"signature-pad-wrapper\" style=\"width:402px;height:202px\"><div data-wrapper-react=\"true\"><!--[if IE 7]><script type=\"text\/javascript\" src=\"\/js\/vendor\/json2.js\"><\/script><![endif]--><\/div><div class=\"signature-line signature-wrapper\" data-component=\"signature\" style=\"width:402px;height:202px\"><div id=\"sig_pad_52\" data-width=\"400\" data-height=\"200\" data-id=\"52\" data-required=\"true\" class=\"pad validate[required]\"><\/div><input type=\"hidden\" name=\"q52_signature\" class=\"output4\" id=\"input_52\"\/><\/div><span class=\"clear-pad-btn clear-pad\">Clear<\/span><label class=\"jfField-sublabel\" for=\"input_52\"><\/label><\/div><div data-wrapper-react=\"true\"><script type=\"text\/javascript\">window.signatureForm = true<\/script><\/div><\/div><\/div><\/div><div class=\"jfCard-actions\"><button style=\"display:block\" type=\"button\" class=\"jfInput-button forPrev u-left\" data-component=\"button\" aria-label=\"Previous\">Previous<\/button><button style=\"display:none\" type=\"button\" class=\"jfInput-button forNext u-right\" data-component=\"button\" aria-label=\"Next\">Next<\/button><button style=\"display:block\" type=\"submit\" class=\"jfInput-button forSubmit form-submit-button u-right\" data-component=\"button\" aria-label=\"Submit\">Submit<\/button><div class=\"cf\"><div class=\"jfCard-actionsNotification\"><div class=\"jfPressEnter isHidden\">Press<br\/>Enter<\/div><\/div><\/div><div class=\"jfCard-disableSubmitError\"><\/div><\/div><\/div><\/div><\/li><li style=\"display:none\">Should be Empty:<input type=\"text\" name=\"website\" value=\"\" aria-hidden=\"true\"\/><\/li><\/ul><\/form><\/div><input type=\"hidden\" aria-hidden=\"true\" id=\"simple_spc\" name=\"simple_spc\" value=\"&quot;92178426315863-92178426315863&quot;\"\/><div class=\"js-overlayWrapper jfOverlay\" aria-hidden=\"true\"><div class=\"jfOverlay-modalWrapper js-overlay-modalWrapper\"><span class=\"jfOverlay-close\"><span class=\"iconSvg  close \"><svg data-name=\"Layer 1\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 209.37 209.37\"><path d=\"M104.1,94.23c-5.83-6-11.26-11.65-16.79-17.2C75.06,64.72,62.72,52.5,50.5,40.17c-1.61-1.63-2.65-1.87-4.22,0a53.62,53.62,0,0,1-5.62,5.61c-1.83,1.58-1.87,2.65-.07,4.42C50.95,60.34,61.17,70.65,71.45,80.91,79,88.46,86.6,96,94.5,103.84L38.58,160l9.18,9.74,56.09-56.38,56.38,56.56,10.38-10.36-56.16-55.81c10-10,19.95-20,29.87-29.88,8-8,16-15.91,23.94-23.94,0.66-.66,1.31-2.42,1-2.78-2.8-3.08-5.82-6-9.24-9.36Z\"><\/path><\/svg><\/span><\/span><img class=\"js-overlayImage jfOverlayImage\" alt=\"close\"\/><\/div><\/div><script src=\"https:\/\/cdn.jotfor.ms\/cardforms\/layout.min.js?e0074e2b\"><\/script><script src=\"https:\/\/www.jotform.com\/ownerView.php?id=92178426315863\"><\/script><script>window.CardForm = new 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