    <script type="text/javascript">
      jQuery(document).ready(function() {
        /////////////////////
        // Readonly Fields //
        /////////////////////
        jQuery('li.gf_readonly textarea, li.gf_readonly input').attr('readonly','readonly');
        jQuery('li.gf_readonly select option').each(function() {
          if (this.selected && (this.text !== '--' || this.text !== '')) {
            jQuery(this).parent().attr('readonly','readonly').trigger('chosen:updated');
          }
        });
   
        // /////////////////////
        // // Disabled Fields //
        // /////////////////////
        // 
        // We are handling this feature in the theme ss-footer.js file instead due to specific req. for the theme
        // 
        // jQuery('li.gf_disabled textarea, li.gf_disabled input').attr('disabled','disabled');
        // jQuery('li.gf_disabled select option').each(function() {
        //   if (this.selected && this.text !== '--' && this.text !== '') {
        //     jQuery(this).parent().attr('disabled','disabled');
        //   }
        // });
        // // differences described here: http://stackoverflow.com/a/7730719/634386
      });

      ////////////////////////////
      // DatePicker Alterations //
      ////////////////////////////
      if (typeof gform !== 'undefined') {
        gform.addFilter( 'gform_datepicker_options_pre_init', function( optionsObj, formId, fieldId ) {
          optionsObj.firstDay = 0;
          /*
          if ( formId == 7 && fieldId == 62 ) {
            optionsObj.minDate = '+1d';
          }
          if ( formId == 7 && fieldId == 47 ) {
            optionsObj.maxDate = '-14y';
          }
          */
          if ( formId == 4 && fieldId == 10 ) {
            optionsObj.minDate = '+2d';
          }
          if ((formId == 3 && fieldId == 29) ||
              (formId == 4 && fieldId == 10)) {
              // optionsObj.firstDay = 1;
              optionsObj.beforeShowDay = jQuery.datepicker.noWeekends;
          }
          return optionsObj;
        });
      }
    </script>
    {"id":3017,"date":"2016-01-21T21:20:08","date_gmt":"2016-01-22T03:20:08","guid":{"rendered":"https:\/\/uuu.smartstartcanada.ca\/manitoba-install-form\/"},"modified":"2020-11-30T14:06:25","modified_gmt":"2020-11-30T20:06:25","slug":"manitoba-install-form","status":"publish","type":"page","link":"https:\/\/old.smartstartcanada.ca\/fr\/manitoba\/manitoba-install-form\/","title":{"rendered":"Manitoba Install Form"},"content":{"rendered":"<h3>Please allow 2 business days to receive your response.<\/h3>\n<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 gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_28' >\n                        <div class='gform_heading'>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_28'  action='\/fr\/wp-json\/wp\/v2\/pages\/3017' data-formid='28' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_28' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_28_59\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_59'><span class='gform-field-label__text'>URL<\/span><\/label><div class='ginput_container'><input name='input_59' id='input_28_59' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_28_59'>This field is for validation purposes and should be left unchanged.<\/div><\/li><li id=\"field_28_1\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p>Please ensure that all of the below information is accurate. Information that is incomplete, or not accurate, will cause delays in the processing of your appointment.<\/p><\/li><\/ul><fieldset class=\"gfieldset gform_fieldset_begin gform_fieldset \"><legend class=\"gfieldset-legend\">Program Information<\/legend><ul class=\"gform_fields top_label form_sublabel_below description_below validation_below\"><li id=\"field_28_4\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you have your Letter of Approval from Manitoba Public Insurance (MPI)?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_28_4'>\n\t\t\t<li class='gchoice gchoice_28_4_0'>\n\t\t\t\t<input name='input_4' type='radio' value='Yes, I have this and I will bring it'  id='choice_28_4_0'    \/>\n\t\t\t\t<label for='choice_28_4_0' id='label_28_4_0' class='gform-field-label gform-field-label--type-inline'>Yes, I have this and I will bring it<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_28_4_1'>\n\t\t\t\t<input name='input_4' type='radio' value='No, I do not have this yet'  id='choice_28_4_1'    \/>\n\t\t\t\t<label for='choice_28_4_1' id='label_28_4_1' class='gform-field-label gform-field-label--type-inline'>No, I do not have this yet<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_28_42\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Are you in possession of your Restricted Driver&#039;s License?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_28_42'>\n\t\t\t<li class='gchoice gchoice_28_42_0'>\n\t\t\t\t<input name='input_42' type='radio' value='Yes, I have this and I will bring it'  id='choice_28_42_0'    \/>\n\t\t\t\t<label for='choice_28_42_0' id='label_28_42_0' class='gform-field-label gform-field-label--type-inline'>Yes, I have this and I will bring it<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_28_42_1'>\n\t\t\t\t<input name='input_42' type='radio' value='No, I do not have this yet'  id='choice_28_42_1'    \/>\n\t\t\t\t<label for='choice_28_42_1' id='label_28_42_1' class='gform-field-label gform-field-label--type-inline'>No, I do not have this yet<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_28_57\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Transitioning Client?<\/span><\/label><div class='gfield_description' id='gfield_description_28_57'>Have you previously had an interlock device with Alcolock and are scheduling a change to Smart Start?<\/div><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_28_57'>\n\t\t\t<li class='gchoice gchoice_28_57_0'>\n\t\t\t\t<input name='input_57' type='radio' value='No, this is a New Install'  id='choice_28_57_0'    \/>\n\t\t\t\t<label for='choice_28_57_0' id='label_28_57_0' class='gform-field-label gform-field-label--type-inline'>No, this is a New Install<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_28_57_1'>\n\t\t\t\t<input name='input_57' type='radio' value='Yes, I am a Transitioning Client'  id='choice_28_57_1'    \/>\n\t\t\t\t<label for='choice_28_57_1' id='label_28_57_1' class='gform-field-label gform-field-label--type-inline'>Yes, I am a Transitioning Client<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><\/ul><\/fieldset><fieldset class=\"gfieldset gform_fieldset_begin gform_fieldset \"><legend class=\"gfieldset-legend\">Personal Information<\/legend><ul class=\"gform_fields top_label form_sublabel_below description_below validation_below\"><li id=\"field_28_9\" class=\"gfield gfield--type-text gfield--input-type-text gf_left_third 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_28_9'><span class='gform-field-label__text'>First Name (required)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_28_9' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_28_10\" class=\"gfield gfield--type-text gfield--input-type-text gf_middle_third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_10'><span class='gform-field-label__text'>Middle Name<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_28_10' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_28_11\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_third 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_28_11'><span class='gform-field-label__text'>Last Name (required)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_28_11' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_28_8\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gf_left_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_28_8'><span class='gform-field-label__text'>Date of Birth (required)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='YYYY-MM-DD'\n\t\t\t\t\tid='input_28_8'\n\t\t\t\t\tclass='datepicker gform-datepicker ymd_dash datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_8'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\taria-required=\"true\"\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"9999-99-99\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_28_8' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_28_8' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_28_8' aria-label='Date of Birth (required): Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/li><li id=\"field_28_12\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gf_left_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_28_12'><span class='gform-field-label__text'>Cell Phone Number (required)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_12' id='input_28_12' type='tel' value='' class='medium'  placeholder='(999) 999-9999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/li><li id=\"field_28_13\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gf_right_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_28_13'><span class='gform-field-label__text'>Home Phone Number<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_13' id='input_28_13' type='tel' value='' class='medium'  placeholder='(999) 999-9999'  aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/li><li id=\"field_28_15\" class=\"gfield gfield--type-email gfield--input-type-email gf_left_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_28_15'><span class='gform-field-label__text'>Email Address (required)<\/span><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_15' id='input_28_15' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_28_14\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_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_28_14'><span class='gform-field-label__text'>Driver&#039;s License Number (required)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_14' id='input_28_14' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><\/ul><\/fieldset><fieldset class=\"gfieldset gform_fieldset_begin gform_fieldset \"><legend class=\"gfieldset-legend\">Address<\/legend><ul class=\"gform_fields top_label form_sublabel_below description_below validation_below\"><li id=\"field_28_20\" class=\"gfield gfield--type-text gfield--input-type-text gf_left_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_28_20'><span class='gform-field-label__text'>Street Address (required)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_20' id='input_28_20' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_28_21\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_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_28_21'><span class='gform-field-label__text'>City\/Town (required)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_21' id='input_28_21' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_28_23\" class=\"gfield gfield--type-select gfield--input-type-select gf_left_half 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><label class='gfield_label gform-field-label' for='input_28_23'><span class='gform-field-label__text'>Province<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_23' id='input_28_23' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Alberta' >Alberta<\/option><option value='British Columbia' >British Columbia<\/option><option value='Manitoba' selected='selected'>Manitoba<\/option><option value='Ontario' >Ontario<\/option><option value='Quebec' >Qu\u00e9bec<\/option><option value='Saskatchewan' >Saskatchewan<\/option><\/select><\/div><\/li><li id=\"field_28_22\" class=\"gfield gfield--type-text gfield--input-type-text 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><label class='gfield_label gform-field-label' for='input_28_22'><span class='gform-field-label__text'>Country<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_28_22' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_28_24\" class=\"gfield gfield--type-text gfield--input-type-text gf_left_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_28_24'><span class='gform-field-label__text'>Postal Code (required)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_24' id='input_28_24' type='text' value='' class='medium'    placeholder='a9a 9a9' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"a9a 9a9\"\/><\/div><\/li><\/ul><\/fieldset><fieldset class=\"gfieldset gform_fieldset_begin gform_fieldset \"><legend class=\"gfieldset-legend\">Additional Info<\/legend><ul class=\"gform_fields top_label form_sublabel_below description_below validation_below\"><li id=\"field_28_45\" class=\"gfield gfield--type-text gfield--input-type-text gf_left_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_28_45'><span class='gform-field-label__text'>Next of Kin (Name - Relation)<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_45' id='input_28_45' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_28_47\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gf_right_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_28_47'><span class='gform-field-label__text'>Next of Kin Phone Number<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_47' id='input_28_47' type='tel' value='' class='medium'  placeholder='(999) 999-9999'  aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/li><\/ul><\/fieldset><fieldset class=\"gfieldset gform_fieldset_begin gform_fieldset \"><legend class=\"gfieldset-legend\">Installation<\/legend><ul class=\"gform_fields top_label form_sublabel_below description_below validation_below\"><li id=\"field_28_29\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gf_left_half field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_29'><span class='gform-field-label__text'>Preferred Installation Date<\/span><\/label><div class='gfield_description' id='gfield_description_28_29'>Please provide a minimum of 2 days from the current date.\nPlease do not request Saturday or Sunday, the appointment may not be honored.<\/div><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='YYYY-MM-DD'\n\t\t\t\t\tid='input_28_29'\n\t\t\t\t\tclass='datepicker gform-datepicker ymd_dash datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_29'\n\t\t\t\t\tvalue=''\n\t\t\t\t\taria-describedby=\"gfield_description_28_29\" \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\t\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"9999-99-99\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_28_29' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_28_29' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_28_29' aria-label='Preferred Installation Date: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/li><li id=\"field_28_30\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_inline field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label screen-reader-text' ><span class='gform-field-label__text'><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_28_30'>\n\t\t\t<li class='gchoice gchoice_28_30_0'>\n\t\t\t\t<input name='input_30' type='radio' value='morning'  id='choice_28_30_0'    \/>\n\t\t\t\t<label for='choice_28_30_0' id='label_28_30_0' class='gform-field-label gform-field-label--type-inline'>Morning<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_28_30_1'>\n\t\t\t\t<input name='input_30' type='radio' value='afternoon'  id='choice_28_30_1'    \/>\n\t\t\t\t<label for='choice_28_30_1' id='label_28_30_1' class='gform-field-label gform-field-label--type-inline'>Afternoon<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_28_48\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gf_left_half field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_48'><span class='gform-field-label__text'>Secondary Installation Date<\/span><\/label><div class='gfield_description' id='gfield_description_28_48'>Please provide a minimum of 3 days from the current date.\nPlease do not request Saturday or Sunday, the appointment may not be honored.<\/div><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='YYYY-MM-DD'\n\t\t\t\t\tid='input_28_48'\n\t\t\t\t\tclass='datepicker gform-datepicker ymd_dash datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_48'\n\t\t\t\t\tvalue=''\n\t\t\t\t\taria-describedby=\"gfield_description_28_48\" \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\t\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"9999-99-99\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_28_48' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_28_48' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_28_48' aria-label='Secondary Installation Date: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/li><li id=\"field_28_49\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_inline field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label screen-reader-text' ><span class='gform-field-label__text'><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_28_49'>\n\t\t\t<li class='gchoice gchoice_28_49_0'>\n\t\t\t\t<input name='input_49' type='radio' value='morning'  id='choice_28_49_0'    \/>\n\t\t\t\t<label for='choice_28_49_0' id='label_28_49_0' class='gform-field-label gform-field-label--type-inline'>Morning<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_28_49_1'>\n\t\t\t\t<input name='input_49' type='radio' value='afternoon'  id='choice_28_49_1'    \/>\n\t\t\t\t<label for='choice_28_49_1' id='label_28_49_1' class='gform-field-label gform-field-label--type-inline'>Afternoon<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><\/ul><\/fieldset><fieldset class=\"gfieldset gform_fieldset_begin gform_fieldset \"><legend class=\"gfieldset-legend\">Vehicle Information<\/legend><ul class=\"gform_fields top_label form_sublabel_below description_below validation_below\"><li id=\"field_28_35\" class=\"gfield gfield--type-text gfield--input-type-text gf_left_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_28_35'><span class='gform-field-label__text'>Vehicle Year (required)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_35' id='input_28_35' type='text' value='' class='medium'    placeholder='YYYY' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"9999\"\/><\/div><\/li><li id=\"field_28_36\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_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_28_36'><span class='gform-field-label__text'>Vehicle Make (required)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_36' id='input_28_36' type='text' value='' class='medium'    placeholder='E.g., Toyota' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_28_37\" class=\"gfield gfield--type-text gfield--input-type-text gf_left_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_28_37'><span class='gform-field-label__text'>Vehicle Model (required)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_37' id='input_28_37' type='text' value='' class='medium'    placeholder='E.g., Camry' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_28_41\" class=\"gfield gfield--type-select gfield--input-type-select gf_right_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_28_41'><span class='gform-field-label__text'>Vehicle Start Type (required)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_41' id='input_28_41' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>-- Select --<\/option><option value='Push Button' >Push Button<\/option><option value='Standard Vehicle' >Standard Vehicle<\/option><option value='Hybrid\/Electric' >Hybrid\/Electric<\/option><option value='Other\/Exotic' >Other\/Exotic<\/option><option value='Motorcycle' >Motorcycle<\/option><\/select><\/div><\/li><li id=\"field_28_50\" class=\"gfield gfield--type-text gfield--input-type-text gf_left_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_28_50'><span class='gform-field-label__text'>Vehicle Colour (required)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_50' id='input_28_50' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_28_39\" class=\"gfield gfield--type-text gfield--input-type-text gf_left_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_28_39'><span class='gform-field-label__text'>Vehicle Identification Number [VIN] (required)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_39' id='input_28_39' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_28_40\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_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_28_40'><span class='gform-field-label__text'>License Plate Number (required)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_40' id='input_28_40' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_28_58\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_58'><span class='gform-field-label__text'>Additional Notes<\/span><\/label><div class='gfield_description' id='gfield_description_28_58'>This can be used for additional details, e.g., you are hearing impaired and require a light-indicator for device notifications in the car, etc.<\/div><div class='ginput_container ginput_container_textarea' data-text-counter-max='250' data-text-counter-template='{current} of {max} max characters'><textarea name='input_58' id='input_28_58' class='textarea medium'  aria-describedby=\"gfield_description_28_58\" maxlength='250'   aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><\/ul><\/fieldset><\/div>\n        <div class='gform-footer gform_footer top_label'> <button type='submit' id='gform_submit_button_28' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Submit<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_28' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_28' id='gform_theme_28' value='legacy' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_28' id='gform_style_settings_28' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_28' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='28' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='CAD' value='3JZRCgKObYwRPReo0wwcpA4ksU9fgX44CoZGI\/Mt2A1sat7v\/ZeZEz5jzKGS2pS19fPcRS3LLZqhXC6c\/quBVRJcZ5hv70ien5tHWmNc+14v3lI=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_28' value='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' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_28' id='gform_target_page_number_28' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_28' id='gform_source_page_number_28' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div>\n<h6>Smart Start will only share information with the client unless the client is under 18 years old. No information will be given to immediate family or a 3rd party. In the event that a minor requires interlock, then a signature from a guardian is required. Also, a guardian is required to be at the installation and removal of the interlock for anyone under 18 years old.<\/h6>\n","protected":false},"excerpt":{"rendered":"<p>Please allow 2 business days to receive your response. Smart Start will only share information with the client unless the client is under 18 years old. No information will be&#8230;<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":3093,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"_acf_changed":false,"footnotes":"","_members_access_role":[],"_members_access_error":""},"class_list":["post-3017","page","type-page","status-publish","hentry","wpautop"],"acf":[],"_links":{"self":[{"href":"https:\/\/old.smartstartcanada.ca\/fr\/wp-json\/wp\/v2\/pages\/3017","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/old.smartstartcanada.ca\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/old.smartstartcanada.ca\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/old.smartstartcanada.ca\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/old.smartstartcanada.ca\/fr\/wp-json\/wp\/v2\/comments?post=3017"}],"version-history":[{"count":0,"href":"https:\/\/old.smartstartcanada.ca\/fr\/wp-json\/wp\/v2\/pages\/3017\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/old.smartstartcanada.ca\/fr\/wp-json\/wp\/v2\/pages\/3093"}],"wp:attachment":[{"href":"https:\/\/old.smartstartcanada.ca\/fr\/wp-json\/wp\/v2\/media?parent=3017"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}