{"id":332,"date":"2024-06-19T14:51:52","date_gmt":"2024-06-19T13:51:52","guid":{"rendered":"https:\/\/partnershipone.com\/TDC\/?page_id=332"},"modified":"2025-01-13T11:15:39","modified_gmt":"2025-01-13T11:15:39","slug":"council-tax-support-already-receiving-uc","status":"publish","type":"page","link":"https:\/\/partnershipone.com\/TDC\/council-tax-support-already-receiving-uc\/","title":{"rendered":"Apply for Council Tax Support if you are already receiving Universal Credit"},"content":{"rendered":"<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(0, 85, 126, 0.8);}<\/style><div id='gf_17' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data'  id='gform_17'  action='\/TDC\/wp-json\/wp\/v2\/pages\/332#gf_17' data-formid='17' novalidate><div id='gf_page_steps_17' class='gf_page_steps'><div id='gf_step_17_1' class='gf_step gf_step_active gf_step_first'><span class='gf_step_number'>1<\/span><span class='gf_step_label'>Using the form<\/span><\/div><div id='gf_step_17_2' class='gf_step gf_step_next gf_step_pending'><span class='gf_step_number'>2<\/span><span class='gf_step_label'>Declaration<\/span><\/div><div id='gf_step_17_3' class='gf_step gf_step_pending'><span class='gf_step_number'>3<\/span><span class='gf_step_label'>About you<\/span><\/div><div id='gf_step_17_4' class='gf_step gf_step_pending'><span class='gf_step_number'>4<\/span><span class='gf_step_label'>About you (continued)<\/span><\/div><div id='gf_step_17_5' class='gf_step gf_step_pending'><span class='gf_step_number'>5<\/span><span class='gf_step_label'>About your living situation<\/span><\/div><div id='gf_step_17_6' class='gf_step gf_step_pending'><span class='gf_step_number'>6<\/span><span class='gf_step_label'>About your partner<\/span><\/div><div id='gf_step_17_7' class='gf_step gf_step_pending'><span class='gf_step_number'>7<\/span><span class='gf_step_label'>About any children who live with you<\/span><\/div><div id='gf_step_17_8' class='gf_step gf_step_pending'><span class='gf_step_number'>8<\/span><span class='gf_step_label'>About any other adults who live with you<\/span><\/div><div id='gf_step_17_9' class='gf_step gf_step_pending'><span class='gf_step_number'>9<\/span><span class='gf_step_label'>About any benefits<\/span><\/div><div id='gf_step_17_10' class='gf_step gf_step_pending'><span class='gf_step_number'>10<\/span><span class='gf_step_label'>About any proof<\/span><\/div><div id='gf_step_17_11' class='gf_step gf_step_last gf_step_pending'><span class='gf_step_number'>11<\/span><span class='gf_step_label'>Any other information<\/span><\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_17_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_17' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_17_24\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  >This form is only to be used by customers who are currently receiving an award of Universal Credit, if this is not the case you will need to complete the <a href=\"https:\/\/www.thanet.gov.uk\/info-pages\/council-tax-support\/\" target=\"_blank\">Council Tax support form<\/a> instead.\n<p><\/p>\n<h3>This form will ask you to provide<\/h3><\/p>\n<p><ul style=\"list-style-type:disc\">\n  <li>your details including National Insurance number<\/li>\n  <li>details of any adults or children who normally live with you<\/li>\n  <li>details of any benefits<\/li>\n  <li>proof to support your application for example, proof of identity, proof of National Insurance number<\/li>\n<\/ul><\/p>\n\n<p>Please have this information ready as pages time-out after one hour.<\/p>\n\n<p>Do not use your browser back button &#8211; if you need to go to a previous page click on the previous button at the bottom of each page.<\/p>\n\n<h4>Privacy Statement<\/h4>\n\n<p>To provide this service Thanet District Council will collect and process personal information. We may check some of the information with other sources (e.g. government departments and other councils) to verify your identity and ensure that the information you have provided is accurate.<\/p>\n\n<p>Your personal information is being processed because it is necessary for compliance with a legal obligation or for the performance of a task carried out in the public interest.<\/p>\n\n<p>Please refer to our&nbsp;<a href=\"https:\/\/www.thanet.gov.uk\/privacy-statement\/\" target=\"_blank\">Corporate Privacy Notice<\/a>&nbsp;for further details on how we process your personal information and your rights. This is also available in other formats (e.g. print).<\/p>\n<\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_17_26' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Begin form'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_17_2' class='gform_page' data-js='page-field-id-26' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_17_2' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_17_53\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Declaration<\/h3><\/div><fieldset id=\"field_17_52\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you filling in this form for you or on behalf of someone else?<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_17_52'>\n\t\t\t<div class='gchoice gchoice_17_52_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_52' type='radio' value='I am filling in this form for me'  id='choice_17_52_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_52_0' id='label_17_52_0' class='gform-field-label gform-field-label--type-inline'>I am filling in this form for me<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_52_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_52' type='radio' value='I am filling in this form on behalf of someone else'  id='choice_17_52_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_52_1' id='label_17_52_1' class='gform-field-label gform-field-label--type-inline'>I am filling in this form on behalf of someone else<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_27\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><ul style=\"list-style-type:disc\">\nPlease check the box below to confirm that you have read, understand and agree to the following statements before completing this form:<p><\/p>\n\n  <li>I confirm the details I will give are correct and true.<\/li>\n  <li>I understand that if I give information that is false this could lead to a penalty or legal proceedings being taken against me.\n<\/li>\n  <li>I agree that you will use the information I have provided to process my claim for Housing Benefit or Council Tax Support, or both. You may check some of the information with other sources as allowed by the law.<\/li>\n  <li>I understand that you may use any information I have provided in connection with this and any other claim for social security benefits that I have made or may make. You may give some information to other organisations, such as government departments, local authorities and private-sector companies such as banks and organisations that may lend me money, where the law allows this.<\/li>\n  <li>I know that I must tell you straight away in writing about any change in my circumstances which might affect my claim.<\/li>\n<\/ul>\n<\/div><div id=\"field_17_55\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_17_54\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><ul style=\"list-style-type:disc\">\nPlease check the box below to confirm that you have read, understand and agree to the following statements before completing this form:<p><\/p>\n\n  <li>As far as possible, I will confirm with the person claiming that the answers I will give on this form are correct and that the documents I will upload as proof are original copies and have not been edited in any way.\n<\/li>\n  <li>I understand that if I give information that is false this could lead to a penalty or legal proceedings being taken against me.\n<\/li>\n  <li>I understand my data may be shared with other departments as permitted by law.\n<\/li>\n<\/ul><\/div><div id=\"field_17_63\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_17_6\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Declaration<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_6.1' id='input_17_6_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_17_6_1' >I understand and accept the above declaration<\/label><input type='hidden' name='input_6.2' value='I understand and accept the above declaration' class='gform_hidden' \/><input type='hidden' name='input_6.3' value='24' class='gform_hidden' \/><\/div><\/fieldset><div id=\"field_17_62\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><div class='gsection_description' id='gfield_description_17_62'>We will not be able to discuss the claim with the person who is completing the form on the claimant\u2019s behalf unless they provide written permission to do so, unless you are already an appointee, have lasting power of attorney or are a court appointed deputy.<\/div><\/div><div id=\"field_17_57\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_57'>I am filling in this form on behalf of<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_57' id='input_17_57' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_58\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_58'>As they cannot fill in the form because<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_58' id='input_17_58' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_207\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is the claimant aware that you are completing this form on their behalf?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_207'>\n\t\t\t<div class='gchoice gchoice_17_207_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_207' type='radio' value='Yes'  id='choice_17_207_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_207_0' id='label_17_207_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_17_207_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_207' type='radio' value='No'  id='choice_17_207_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_207_1' id='label_17_207_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_60\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_60'>Full name of the person completing this form<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_60' id='input_17_60' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_56\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_56'>Relationship to the person claiming<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_56' id='input_17_56' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_59\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_59'>Contact email address or phone number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_17_59'>We might need to contact you to check the information you&#8217;ve given us<\/div><div class='ginput_container ginput_container_text'><input name='input_59' id='input_17_59' type='text' value='' class='large'  aria-describedby=\"gfield_description_17_59\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_17_8' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_17_8' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_17_3' class='gform_page' data-js='page-field-id-8' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_17_3' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_17_208\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above 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><h3 class=\"gsection_title\">About Universal Credit<\/h3><\/div><fieldset id=\"field_17_198\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above 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' >Are you currently receiving Universal Credit?<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_17_198'>\n\t\t\t<div class='gchoice gchoice_17_198_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_198' type='radio' value='Yes, I am currently receiving Universal Credit'  id='choice_17_198_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_198_0' id='label_17_198_0' class='gform-field-label gform-field-label--type-inline'>Yes, I am currently receiving Universal Credit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_198_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_198' type='radio' value='No, I am not receiving Universal Credit'  id='choice_17_198_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_198_1' id='label_17_198_1' class='gform-field-label gform-field-label--type-inline'>No, I am not receiving Universal Credit<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_200\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above 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><h3 class=\"gsection_title\">Not receiving Universal Credit<\/h3><\/div><div id=\"field_17_201\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  >You need to apply for Council Tax Support.  <a href=\"https:\/\/www.thanet.gov.uk\/info-pages\/council-tax-support\/\">Make a claim for Council Tax Support<\/a>\n<\/div><div id=\"field_17_167\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About you (the claimant)<\/h3><\/div><div id=\"field_17_471\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_471'>Benefit account reference<\/label><div class='ginput_container ginput_container_text'><input name='input_471' id='input_17_471' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_44\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_44'>Title (for example Mr, Mrs, Ms, Miss)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_44' id='input_17_44' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_45\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_45'>First name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_45' id='input_17_45' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_46\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_46'>Last name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_46' id='input_17_46' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_51\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_51'>Contact phone number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_17_51'>Please provide a mobile number if you have one as we are now using text messaging (SMS) to contact some of our residents.<\/div><div class='ginput_container ginput_container_text'><input name='input_51' id='input_17_51' type='text' value='' class='large'  aria-describedby=\"gfield_description_17_51\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_11\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Email address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_17_11'>We will use your email address to send the receipt of your form, including the form reference number. This may include personal data. We will also use your email address to contact you about your Council Tax account and\/or benefits.<\/div><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_17_11_container'>\n                                <span id='input_17_11_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <label for='input_17_11' class='gform-field-label gform-field-label--type-sub '>Enter email address<\/label>\n                                    <input class='' type='email' name='input_11' id='input_17_11' value=''    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_17_11\" \/>\n                                <\/span>\n                                <span id='input_17_11_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <label for='input_17_11_2' class='gform-field-label gform-field-label--type-sub '>Confirm email address<\/label>\n                                    <input class='' type='email' name='input_11_2' id='input_17_11_2' value=''    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_17_11\" \/>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><fieldset id=\"field_17_13\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Would you like to receive your Council Tax bills by email?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_17_13'>You can receive your Council Tax bills and benefit notifications by email rather than post. We will send all future Council Tax bills and benefit notifications to the email address you have given above. This service is only available to people who are named on the bill. If you change your email address you must let us know straight away. You can opt out of this at any time at thanet.gov.uk\/paperless.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_13'>\n\t\t\t<div class='gchoice gchoice_17_13_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='Yes'  id='choice_17_13_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_17_13\"   \/>\n\t\t\t\t\t<label for='choice_17_13_0' id='label_17_13_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_17_13_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='No'  id='choice_17_13_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_13_1' id='label_17_13_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_66\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date of birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_17_66' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_17_66_2_container'><label for='input_17_66_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_66[]' id='input_17_66_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_17_66_1_container'><label for='input_17_66_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_66[]' id='input_17_66_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_17_66_3_container'><label for='input_17_66_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_66[]' id='input_17_66_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_17_65\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_65'>National Insurance number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_65' id='input_17_65' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_203\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_203'>Nationality<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_203' id='input_17_203' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_115\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About your address<\/h3><\/div><fieldset id=\"field_17_169\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_17_169'>If you are renting a room include the room number<\/div>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_state has_zip ginput_container_address gform-grid-row' id='input_17_169' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_17_169_1_container' >\n                                        <label for='input_17_169_1' id='input_17_169_1_label' class='gform-field-label gform-field-label--type-sub '>Address line 1<\/label>\n                                        <input type='text' name='input_169.1' id='input_17_169_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_17_169_2_container' >\n                                        <label for='input_17_169_2' id='input_17_169_2_label' class='gform-field-label gform-field-label--type-sub '>Address line 2<\/label>\n                                        <input type='text' name='input_169.2' id='input_17_169_2' value=''     aria-required='false'   \/>\n                                    <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_17_169_4_container' >\n                                        <label for='input_17_169_4' id='input_17_169_4_label' class='gform-field-label gform-field-label--type-sub '>Town or city<\/label>\n                                        <input type='text' name='input_169.4' id='input_17_169_4' value=''      aria-required='true'    \/>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_17_169_5_container' >\n                                    <label for='input_17_169_5' id='input_17_169_5_label' class='gform-field-label gform-field-label--type-sub '>Postcode<\/label>\n                                    <input type='text' name='input_169.5' id='input_17_169_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_169.6' id='input_17_169_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_17_441\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >What date did you move into this address?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_17_441' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_17_441_2_container'><label for='input_17_441_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_441[]' id='input_17_441_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_17_441_1_container'><label for='input_17_441_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_441[]' id='input_17_441_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_17_441_3_container'><label for='input_17_441_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_441[]' id='input_17_441_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_17_218' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_17_218' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_17_4' class='gform_page' data-js='page-field-id-218' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_17_4' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_17_219\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About you (the claimant) continued<\/h3><\/div><fieldset id=\"field_17_232\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you a full time student?<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_17_232'>\n\t\t\t<div class='gchoice gchoice_17_232_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_232' type='radio' value='Yes'  id='choice_17_232_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_232_0' id='label_17_232_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_17_232_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_232' type='radio' value='No'  id='choice_17_232_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_232_1' id='label_17_232_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_233\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you already provided a copy of your student certificate?<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_17_233'>\n\t\t\t<div class='gchoice gchoice_17_233_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_233' type='radio' value='Yes'  id='choice_17_233_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_233_0' id='label_17_233_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_17_233_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_233' type='radio' value='No'  id='choice_17_233_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_233_1' id='label_17_233_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_234\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_17_234'>Upload a copy of your  current student certificate<\/label><div class='gfield_description' id='gfield_description_17_234'>If you do not have it available at the moment you can provide it later. <\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_17_234' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_17_234&quot;,&quot;container&quot;:&quot;gform_multifile_upload_17_234&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_17_234&quot;,&quot;filelist&quot;:&quot;gform_preview_17_234&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/?gf_page=da30025ee0527cd&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;3072000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:17,&quot;field_id&quot;:234,&quot;_gform_file_upload_nonce_17_234&quot;:&quot;acd73c88c6&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_17_234&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_17_234' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_17_234' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_17_234 gfield_description_17_234\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_17_234'>Max. file size: 3 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_17_234'><\/ul> <div id='gform_preview_17_234' class='ginput_preview_list'><\/div><\/div><\/div><fieldset id=\"field_17_235\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you an apprentice?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_17_235'>If you or someone living with you is an apprentice, and without them there is only one adult living in your home, you can apply for an <a href=\"https:\/\/www.thanet.gov.uk\/info-pages\/council-tax-discounts-and-exemptions\/?question=850-2\" target=\"_blank\">apprentice discount<\/a>.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_235'>\n\t\t\t<div class='gchoice gchoice_17_235_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_235' type='radio' value='Yes'  id='choice_17_235_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_17_235\"   \/>\n\t\t\t\t\t<label for='choice_17_235_0' id='label_17_235_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_17_235_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_235' type='radio' value='No'  id='choice_17_235_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_235_1' id='label_17_235_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_472\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you a Kent County Council Care Leaver and receive assistance by the &#039;Local Offer for Care Leavers&#039;?<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_17_472'>\n\t\t\t<div class='gchoice gchoice_17_472_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_472' type='radio' value='Yes'  id='choice_17_472_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_472_0' id='label_17_472_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_17_472_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_472' type='radio' value='No'  id='choice_17_472_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_472_1' id='label_17_472_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_237\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you severely mentally impaired?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_17_237'>If everyone living in a property is severely mentally impaired you can apply for an exemption (which means you don\u2019t have to pay Council Tax for the property).  If someone living with you is severely mentally impaired and without them there is only one adult living in your home, you can apply for a 25% discount on your Council Tax.   \nYou can apply for a <a href=\"https:\/\/www.thanet.gov.uk\/info-pages\/council-tax-discounts-and-exemptions\/?question=850-18\" target=\"_blank\">severely mentally impaired discount or exemption<\/a>.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_237'>\n\t\t\t<div class='gchoice gchoice_17_237_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_237' type='radio' value='Yes'  id='choice_17_237_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_17_237\"   \/>\n\t\t\t\t\t<label for='choice_17_237_0' id='label_17_237_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_17_237_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_237' type='radio' value='No'  id='choice_17_237_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_237_1' id='label_17_237_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_239\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you registered blind?<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_17_239'>\n\t\t\t<div class='gchoice gchoice_17_239_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_239' type='radio' value='Yes'  id='choice_17_239_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_239_0' id='label_17_239_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_17_239_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_239' type='radio' value='No'  id='choice_17_239_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_239_1' id='label_17_239_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_240\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Does anyone get Carer&#039;s Allowance or the carer&#039;s element of Universal Credit for looking after you?<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_17_240'>\n\t\t\t<div class='gchoice gchoice_17_240_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_240' type='radio' value='Yes'  id='choice_17_240_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_240_0' id='label_17_240_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_17_240_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_240' type='radio' value='No'  id='choice_17_240_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_240_1' id='label_17_240_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_241\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you temporarily living away from home?<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_17_241'>\n\t\t\t<div class='gchoice gchoice_17_241_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_241' type='radio' value='Yes'  id='choice_17_241_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_241_0' id='label_17_241_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_17_241_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_241' type='radio' value='No'  id='choice_17_241_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_241_1' id='label_17_241_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_242\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >When did you start living away from home?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_17_242' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_17_242_2_container'><label for='input_17_242_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_242[]' id='input_17_242_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_17_242_1_container'><label for='input_17_242_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_242[]' id='input_17_242_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_17_242_3_container'><label for='input_17_242_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_242[]' id='input_17_242_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_17_243\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_243'>Where are you temporarily living and why?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_17_243'>Such as hospital, on remand, if abroad specify the country you are visiting<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_243' id='input_17_243' class='textarea small'  aria-describedby=\"gfield_description_17_243\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_17_244\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_244'>When do you expect to return home?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_244' id='input_17_244' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_17_64' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_17_64' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_17_5' class='gform_page' data-js='page-field-id-64' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_17_5' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_17_67\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About your living situation<\/h3><\/div><fieldset id=\"field_17_72\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you live on your own?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_17_72'>If you have a partner, children or any other adult living in your household, answer No to this question.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_72'>\n\t\t\t<div class='gchoice gchoice_17_72_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='Yes'  id='choice_17_72_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_17_72\"   \/>\n\t\t\t\t\t<label for='choice_17_72_0' id='label_17_72_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_17_72_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='No'  id='choice_17_72_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_72_1' id='label_17_72_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_286\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above 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><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_17_211\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you have a partner living with you?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_17_211'>By partner we mean a person you are married to or a person you live with as if you are married to them or a civil partner or a person you live with as if you are civil partners.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_211'>\n\t\t\t<div class='gchoice gchoice_17_211_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_211' type='radio' value='Yes'  id='choice_17_211_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_17_211\"   \/>\n\t\t\t\t\t<label for='choice_17_211_0' id='label_17_211_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_17_211_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_211' type='radio' value='No'  id='choice_17_211_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_211_1' id='label_17_211_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_260\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above 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><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_17_216\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you have any children who normally live with you?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_17_216'>A child for this question is any child you are or could receive Child Benefit for. So they would be aged under 16, aged 16 or 17 and registered for work or youth training or aged 16 to 19 and in education on a course not higher than GCE A-Level, SCE Higher Level, or GNVQ advanced.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_216'>\n\t\t\t<div class='gchoice gchoice_17_216_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_216' type='radio' value='Yes'  id='choice_17_216_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_17_216\"   \/>\n\t\t\t\t\t<label for='choice_17_216_0' id='label_17_216_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_17_216_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_216' type='radio' value='No'  id='choice_17_216_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_216_1' id='label_17_216_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_285\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above 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><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_17_213\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you have any other adults who live with you (other than your partner if you have one)?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_17_213'>An adult is anyone over the age of 16 that you do not receive Child Benefit for. This includes other family and friends, boarders, subtenants and lodgers. Include any children they have who live in your household.  Don\u2019t tell us about people who just share a hall, bathroom and\/or toilet.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_213'>\n\t\t\t<div class='gchoice gchoice_17_213_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Yes'  id='choice_17_213_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_17_213\"   \/>\n\t\t\t\t\t<label for='choice_17_213_0' id='label_17_213_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_17_213_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='No'  id='choice_17_213_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_213_1' id='label_17_213_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_17_323' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_17_323' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_17_6' class='gform_page' data-js='page-field-id-323' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_17_6' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_17_217\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About your partner who lives with you<\/h3><div class='gsection_description' id='gfield_description_17_217'>By partner we mean:\n<ul style=\"list-style-type:disc\">\n  <li>a person you are married to or a person you live with as if you are married to them or<\/li>\n  <li> a civil partner or a person you live with as if you are civil partners<\/li>\n<\/ul>\n\nPlease provide the following information about your partner:\n<\/div><\/div><div id=\"field_17_227\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_227'>Title (for example Mr, Mrs, Ms, Miss) (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_227' id='input_17_227' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_228\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_228'>First name (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_228' id='input_17_228' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_229\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_229'>Last name (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_229' id='input_17_229' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_220\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_220'>Contact phone number (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_220' id='input_17_220' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_221\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Email address (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_17_221_container'>\n                                <span id='input_17_221_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <label for='input_17_221' class='gform-field-label gform-field-label--type-sub '>Enter email address<\/label>\n                                    <input class='' type='email' name='input_221' id='input_17_221' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                <\/span>\n                                <span id='input_17_221_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <label for='input_17_221_2' class='gform-field-label gform-field-label--type-sub '>Confirm email address<\/label>\n                                    <input class='' type='email' name='input_221_2' id='input_17_221_2' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><fieldset id=\"field_17_224\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date of birth (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_17_224' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_17_224_2_container'><label for='input_17_224_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_224[]' id='input_17_224_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_17_224_1_container'><label for='input_17_224_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_224[]' id='input_17_224_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_17_224_3_container'><label for='input_17_224_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_224[]' id='input_17_224_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_17_223\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_223'>National Insurance number (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_223' id='input_17_223' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_225\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_225'>Nationality (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_225' id='input_17_225' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_245\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they a full time student? (partner)<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_17_245'>\n\t\t\t<div class='gchoice gchoice_17_245_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_245' type='radio' value='Yes'  id='choice_17_245_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_245_0' id='label_17_245_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_17_245_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_245' type='radio' value='No'  id='choice_17_245_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_245_1' id='label_17_245_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_246\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have they already provided a copy of their student certificate? (partner)<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_17_246'>\n\t\t\t<div class='gchoice gchoice_17_246_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_246' type='radio' value='Yes'  id='choice_17_246_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_246_0' id='label_17_246_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_17_246_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_246' type='radio' value='No'  id='choice_17_246_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_246_1' id='label_17_246_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_247\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_17_247'>Upload a copy of their current student certificate (partner)<\/label><div class='gfield_description' id='gfield_description_17_247'>If you do not have it available at the moment you can provide it later. <\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_17_247' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_17_247&quot;,&quot;container&quot;:&quot;gform_multifile_upload_17_247&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_17_247&quot;,&quot;filelist&quot;:&quot;gform_preview_17_247&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/?gf_page=da30025ee0527cd&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;3072000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:17,&quot;field_id&quot;:247,&quot;_gform_file_upload_nonce_17_247&quot;:&quot;359d294ccd&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_17_247&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_17_247' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_17_247' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_17_247 gfield_description_17_247\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_17_247'>Max. file size: 3 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_17_247'><\/ul> <div id='gform_preview_17_247' class='ginput_preview_list'><\/div><\/div><\/div><fieldset id=\"field_17_248\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they an apprentice? (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_17_248'>If you or someone living with you is an apprentice, and without them there is only one adult living in your home, you can apply for an <a href=\"https:\/\/www.thanet.gov.uk\/info-pages\/council-tax-discounts-and-exemptions\/?question=850-2\" target=\"_blank\">apprentice discount<\/a>.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_248'>\n\t\t\t<div class='gchoice gchoice_17_248_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_248' type='radio' value='Yes'  id='choice_17_248_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_17_248\"   \/>\n\t\t\t\t\t<label for='choice_17_248_0' id='label_17_248_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_17_248_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_248' type='radio' value='No'  id='choice_17_248_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_248_1' id='label_17_248_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_250\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they severely mentally impaired? (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_17_250'>If everyone living in a property is severely mentally impaired you can apply for an exemption (which means you don\u2019t have to pay Council Tax for the property).  If someone living with you is severely mentally impaired and without them there is only one adult living in your home, you can apply for a 25% discount on your Council Tax.  \nYou can apply for a <a href=\"https:\/\/www.thanet.gov.uk\/info-pages\/council-tax-discounts-and-exemptions\/?question=850-18\" target=\"_blank\">severely mentally impaired discount or exemption<\/a>.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_250'>\n\t\t\t<div class='gchoice gchoice_17_250_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_250' type='radio' value='Yes'  id='choice_17_250_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_17_250\"   \/>\n\t\t\t\t\t<label for='choice_17_250_0' id='label_17_250_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_17_250_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_250' type='radio' value='No'  id='choice_17_250_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_250_1' id='label_17_250_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_252\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they registered blind? (partner)<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_17_252'>\n\t\t\t<div class='gchoice gchoice_17_252_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_252' type='radio' value='Yes'  id='choice_17_252_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_252_0' id='label_17_252_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_17_252_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_252' type='radio' value='No'  id='choice_17_252_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_252_1' id='label_17_252_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_442\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Does anyone get Carer&#039;s Allowance or the carer&#039;s element of Universal Credit for looking after your partner?<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_17_442'>\n\t\t\t<div class='gchoice gchoice_17_442_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_442' type='radio' value='Yes'  id='choice_17_442_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_442_0' id='label_17_442_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_17_442_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_442' type='radio' value='No'  id='choice_17_442_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_442_1' id='label_17_442_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_253\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they temporarily living away from home? (partner)<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_17_253'>\n\t\t\t<div class='gchoice gchoice_17_253_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_253' type='radio' value='Yes'  id='choice_17_253_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_253_0' id='label_17_253_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_17_253_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_253' type='radio' value='No'  id='choice_17_253_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_253_1' id='label_17_253_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_256\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >When did they start living away from home? (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_17_256' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_17_256_2_container'><label for='input_17_256_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_256[]' id='input_17_256_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_17_256_1_container'><label for='input_17_256_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_256[]' id='input_17_256_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_17_256_3_container'><label for='input_17_256_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_256[]' id='input_17_256_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_17_257\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_257'>Where are they temporarily living and why? (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_17_257'>Such as hospital, on remand, if abroad specify the country they are visiting.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_257' id='input_17_257' class='textarea small'  aria-describedby=\"gfield_description_17_257\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_17_258\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_258'>When do you expect them to return home? (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_258' id='input_17_258' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_17_271' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_17_271' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_17_7' class='gform_page' data-js='page-field-id-271' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_17_7' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_17_230\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the children who live with you<\/h3><div class='gsection_description' id='gfield_description_17_230'>We need to know about any children who normally live with you and\/or who you or your partner get, or have applied for, Child Benefit for.\n<p><\/p>\n<p><\/p>\nA child is:\n<ul style=\"list-style-type:disc\">\n  <li>aged under 16<\/li>\n  <li> aged 16 or 17 and registered for work or youth training, or<\/li>\n  <li>aged 16 to 19 and in education on a course not higher than GCE A-Level, SCE Higher Level, or GNVQ advanced<\/li>\n<\/ul>\n\n<\/div><\/div><div id=\"field_17_284\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the first child<\/h3><\/div><div id=\"field_17_262\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_262'>Full name (child 1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_262' id='input_17_262' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_263\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date of birth (child 1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_17_263' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_17_263_2_container'><label for='input_17_263_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_263[]' id='input_17_263_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_17_263_1_container'><label for='input_17_263_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_263[]' id='input_17_263_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_17_263_3_container'><label for='input_17_263_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_263[]' id='input_17_263_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_17_264\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_264'>Gender (child 1)<\/label><div class='ginput_container ginput_container_text'><input name='input_264' id='input_17_264' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_265\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner receive Child Benefit for this child?  (1)<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_17_265'>\n\t\t\t<div class='gchoice gchoice_17_265_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_265' type='radio' value='Yes'  id='choice_17_265_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_265_0' id='label_17_265_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_17_265_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_265' type='radio' value='No'  id='choice_17_265_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_265_1' id='label_17_265_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_315\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_315'>How much Child Benefit do you receive for this child? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_315' id='input_17_315' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_443\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you applied for Child Benefit for this child? (1)<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_17_443'>\n\t\t\t<div class='gchoice gchoice_17_443_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_443' type='radio' value='Yes'  id='choice_17_443_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_443_0' id='label_17_443_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_17_443_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_443' type='radio' value='No'  id='choice_17_443_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_443_1' id='label_17_443_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_446\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Who receives child benefit for this child? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name of the person receiving the child benefit (1)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Relationship to this child (1)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Number of hours this child spends with them each week (1)<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_446_cell1 gform-grid-col' data-label='Name of the person receiving the child benefit (1)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Name of the person receiving the child benefit (1), Row 1' data-aria-label-template='Name of the person receiving the child benefit (1), Row {0}' type='text' name='input_446[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_446_cell2 gform-grid-col' data-label='Relationship to this child (1)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Relationship to this child (1), Row 1' data-aria-label-template='Relationship to this child (1), Row {0}' type='text' name='input_446[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_446_cell3 gform-grid-col' data-label='Number of hours this child spends with them each week (1)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Number of hours this child spends with them each week (1), Row 1' data-aria-label-template='Number of hours this child spends with them each week (1), Row {0}' type='text' name='input_446[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_266\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is this child registered blind? (1)<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_17_266'>\n\t\t\t<div class='gchoice gchoice_17_266_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_266' type='radio' value='Yes'  id='choice_17_266_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_266_0' id='label_17_266_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_17_266_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_266' type='radio' value='No'  id='choice_17_266_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_266_1' id='label_17_266_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_267\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Has this child been formally placed with you for fostering? (1)<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_17_267'>\n\t\t\t<div class='gchoice gchoice_17_267_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_267' type='radio' value='Yes'  id='choice_17_267_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_267_0' id='label_17_267_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_17_267_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_267' type='radio' value='No'  id='choice_17_267_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_267_1' id='label_17_267_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_269\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Does this child receive any benefits for disability such as Personal Independence Payment or Disability Living Allowance? (1)<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_17_269'>\n\t\t\t<div class='gchoice gchoice_17_269_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_269' type='radio' value='Yes'  id='choice_17_269_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_269_0' id='label_17_269_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_17_269_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_269' type='radio' value='No'  id='choice_17_269_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_269_1' id='label_17_269_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_268\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_268'>What benefit(s) does this child receive? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_268' id='input_17_268' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Personal Independence Payment - daily living and mobility' >Personal Independence Payment &#8211; daily living and mobility<\/option><option value='Personal Independence Payment - daily living only' >Personal Independence Payment &#8211; daily living only<\/option><option value='Personal Independence Payment \u2013 mobility only' >Personal Independence Payment \u2013 mobility only<\/option><option value='Disability Living Allowance - care and mobility components' >Disability Living Allowance &#8211; care and mobility components<\/option><option value='Disability Living Allowance - care component only' >Disability Living Allowance &#8211; care component only<\/option><option value='Disability Living Allowance - mobility component only' >Disability Living Allowance &#8211; mobility component only<\/option><\/select><\/div><\/div><div id=\"field_17_270\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_270'>What is their National Insurance number? (1)<\/label><div class='ginput_container ginput_container_text'><input name='input_270' id='input_17_270' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_272\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is there another child who lives with you? (1)<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_17_272'>\n\t\t\t<div class='gchoice gchoice_17_272_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_272' type='radio' value='Yes'  id='choice_17_272_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_272_0' id='label_17_272_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_17_272_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_272' type='radio' value='No'  id='choice_17_272_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_272_1' id='label_17_272_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_273\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the second child<\/h3><\/div><div id=\"field_17_325\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_325'>Full name (child 2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_325' id='input_17_325' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_326\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date of birth (child 2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_17_326' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_17_326_2_container'><label for='input_17_326_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_326[]' id='input_17_326_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_17_326_1_container'><label for='input_17_326_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_326[]' id='input_17_326_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_17_326_3_container'><label for='input_17_326_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_326[]' id='input_17_326_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_17_327\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_327'>Gender (child 2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_327' id='input_17_327' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_330\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner receive Child Benefit for this child?  (2)<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_17_330'>\n\t\t\t<div class='gchoice gchoice_17_330_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_330' type='radio' value='Yes'  id='choice_17_330_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_330_0' id='label_17_330_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_17_330_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_330' type='radio' value='No'  id='choice_17_330_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_330_1' id='label_17_330_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_331\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_331'>How much Child Benefit do you receive for this child? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_331' id='input_17_331' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_445\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you applied for Child Benefit for this child? (2)<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_17_445'>\n\t\t\t<div class='gchoice gchoice_17_445_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_445' type='radio' value='Yes'  id='choice_17_445_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_445_0' id='label_17_445_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_17_445_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_445' type='radio' value='No'  id='choice_17_445_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_445_1' id='label_17_445_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_444\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Who receives child benefit for this child? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name of the person receiving the child benefit (2)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Relationship to this child (2)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Number of hours this child spends with them each week (2)<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_444_cell1 gform-grid-col' data-label='Name of the person receiving the child benefit (2)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Name of the person receiving the child benefit (2), Row 1' data-aria-label-template='Name of the person receiving the child benefit (2), Row {0}' type='text' name='input_444[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_444_cell2 gform-grid-col' data-label='Relationship to this child (2)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Relationship to this child (2), Row 1' data-aria-label-template='Relationship to this child (2), Row {0}' type='text' name='input_444[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_444_cell3 gform-grid-col' data-label='Number of hours this child spends with them each week (2)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Number of hours this child spends with them each week (2), Row 1' data-aria-label-template='Number of hours this child spends with them each week (2), Row {0}' type='text' name='input_444[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_332\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is this child registered blind? (2)<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_17_332'>\n\t\t\t<div class='gchoice gchoice_17_332_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_332' type='radio' value='Yes'  id='choice_17_332_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_332_0' id='label_17_332_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_17_332_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_332' type='radio' value='No'  id='choice_17_332_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_332_1' id='label_17_332_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_333\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Has this child been formally placed with you for fostering? (2)<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_17_333'>\n\t\t\t<div class='gchoice gchoice_17_333_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_333' type='radio' value='Yes'  id='choice_17_333_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_333_0' id='label_17_333_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_17_333_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_333' type='radio' value='No'  id='choice_17_333_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_333_1' id='label_17_333_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_334\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Does this child receive any benefits for disability such as Personal Independence Payment or Disability Living Allowance? (2)<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_17_334'>\n\t\t\t<div class='gchoice gchoice_17_334_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_334' type='radio' value='Yes'  id='choice_17_334_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_334_0' id='label_17_334_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_17_334_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_334' type='radio' value='No'  id='choice_17_334_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_334_1' id='label_17_334_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_328\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_328'>What benefit(s) does this child receive? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_328' id='input_17_328' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Personal Independence Payment - daily living and mobility' >Personal Independence Payment &#8211; daily living and mobility<\/option><option value='Personal Independence Payment - daily living only' >Personal Independence Payment &#8211; daily living only<\/option><option value='Personal Independence Payment \u2013 mobility only' >Personal Independence Payment \u2013 mobility only<\/option><option value='Disability Living Allowance - care and mobility components' >Disability Living Allowance &#8211; care and mobility components<\/option><option value='Disability Living Allowance - care component only' >Disability Living Allowance &#8211; care component only<\/option><option value='Disability Living Allowance - mobility component only' >Disability Living Allowance &#8211; mobility component only<\/option><\/select><\/div><\/div><div id=\"field_17_329\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_329'>What is their National Insurance number? (2)<\/label><div class='ginput_container ginput_container_text'><input name='input_329' id='input_17_329' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_274\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is there another child who lives with you? (2)<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_17_274'>\n\t\t\t<div class='gchoice gchoice_17_274_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_274' type='radio' value='Yes'  id='choice_17_274_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_274_0' id='label_17_274_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_17_274_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_274' type='radio' value='No'  id='choice_17_274_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_274_1' id='label_17_274_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_275\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the third child<\/h3><\/div><div id=\"field_17_345\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_345'>Full name (child 3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_345' id='input_17_345' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_344\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date of birth (child 3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_17_344' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_17_344_2_container'><label for='input_17_344_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_344[]' id='input_17_344_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_17_344_1_container'><label for='input_17_344_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_344[]' id='input_17_344_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_17_344_3_container'><label for='input_17_344_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_344[]' id='input_17_344_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_17_343\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_343'>Gender (child 3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_343' id='input_17_343' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_342\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner receive Child Benefit for this child?  (3)<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_17_342'>\n\t\t\t<div class='gchoice gchoice_17_342_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_342' type='radio' value='Yes'  id='choice_17_342_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_342_0' id='label_17_342_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_17_342_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_342' type='radio' value='No'  id='choice_17_342_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_342_1' id='label_17_342_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_341\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_341'>How much Child Benefit do you receive for this child? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_341' id='input_17_341' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_447\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you applied for Child Benefit for this child? (3)<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_17_447'>\n\t\t\t<div class='gchoice gchoice_17_447_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_447' type='radio' value='Yes'  id='choice_17_447_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_447_0' id='label_17_447_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_17_447_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_447' type='radio' value='No'  id='choice_17_447_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_447_1' id='label_17_447_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_448\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Who receives child benefit for this child? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name of the person receiving the child benefit (3)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Relationship to this child (3)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Number of hours this child spends with them each week (3)<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_448_cell1 gform-grid-col' data-label='Name of the person receiving the child benefit (3)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Name of the person receiving the child benefit (3), Row 1' data-aria-label-template='Name of the person receiving the child benefit (3), Row {0}' type='text' name='input_448[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_448_cell2 gform-grid-col' data-label='Relationship to this child (3)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Relationship to this child (3), Row 1' data-aria-label-template='Relationship to this child (3), Row {0}' type='text' name='input_448[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_448_cell3 gform-grid-col' data-label='Number of hours this child spends with them each week (3)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Number of hours this child spends with them each week (3), Row 1' data-aria-label-template='Number of hours this child spends with them each week (3), Row {0}' type='text' name='input_448[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_340\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is this child registered blind? (3)<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_17_340'>\n\t\t\t<div class='gchoice gchoice_17_340_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_340' type='radio' value='Yes'  id='choice_17_340_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_340_0' id='label_17_340_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_17_340_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_340' type='radio' value='No'  id='choice_17_340_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_340_1' id='label_17_340_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_339\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Has this child been formally placed with you for fostering? (3)<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_17_339'>\n\t\t\t<div class='gchoice gchoice_17_339_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_339' type='radio' value='Yes'  id='choice_17_339_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_339_0' id='label_17_339_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_17_339_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_339' type='radio' value='No'  id='choice_17_339_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_339_1' id='label_17_339_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_338\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Does this child receive any benefits for disability such as Personal Independence Payment or Disability Living Allowance? (3)<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_17_338'>\n\t\t\t<div class='gchoice gchoice_17_338_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_338' type='radio' value='Yes'  id='choice_17_338_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_338_0' id='label_17_338_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_17_338_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_338' type='radio' value='No'  id='choice_17_338_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_338_1' id='label_17_338_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_336\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_336'>What benefit(s) does this child receive? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_336' id='input_17_336' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Personal Independence Payment - daily living and mobility' >Personal Independence Payment &#8211; daily living and mobility<\/option><option value='Personal Independence Payment - daily living only' >Personal Independence Payment &#8211; daily living only<\/option><option value='Personal Independence Payment \u2013 mobility only' >Personal Independence Payment \u2013 mobility only<\/option><option value='Disability Living Allowance - care and mobility components' >Disability Living Allowance &#8211; care and mobility components<\/option><option value='Disability Living Allowance - care component only' >Disability Living Allowance &#8211; care component only<\/option><option value='Disability Living Allowance - mobility component only' >Disability Living Allowance &#8211; mobility component only<\/option><\/select><\/div><\/div><div id=\"field_17_335\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_335'>What is their National Insurance number? (3)<\/label><div class='ginput_container ginput_container_text'><input name='input_335' id='input_17_335' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_279\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is there another child who lives with you? (3)<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_17_279'>\n\t\t\t<div class='gchoice gchoice_17_279_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_279' type='radio' value='Yes'  id='choice_17_279_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_279_0' id='label_17_279_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_17_279_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_279' type='radio' value='No'  id='choice_17_279_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_279_1' id='label_17_279_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_276\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the fourth child<\/h3><\/div><div id=\"field_17_346\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_346'>Full name (child 4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_346' id='input_17_346' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_372\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date of birth (child 4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_17_372' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_17_372_2_container'><label for='input_17_372_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_372[]' id='input_17_372_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_17_372_1_container'><label for='input_17_372_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_372[]' id='input_17_372_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_17_372_3_container'><label for='input_17_372_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_372[]' id='input_17_372_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_17_369\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_369'>Gender (child 4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_369' id='input_17_369' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_365\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner receive Child Benefit for this child?  (4)<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_17_365'>\n\t\t\t<div class='gchoice gchoice_17_365_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_365' type='radio' value='Yes'  id='choice_17_365_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_365_0' id='label_17_365_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_17_365_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_365' type='radio' value='No'  id='choice_17_365_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_365_1' id='label_17_365_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_362\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_362'>How much Child Benefit do you receive for this child? (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_362' id='input_17_362' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_449\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you applied for Child Benefit for this child? (4)<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_17_449'>\n\t\t\t<div class='gchoice gchoice_17_449_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_449' type='radio' value='Yes'  id='choice_17_449_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_449_0' id='label_17_449_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_17_449_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_449' type='radio' value='No'  id='choice_17_449_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_449_1' id='label_17_449_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_450\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Who receives child benefit for this child? (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name of the person receiving the child benefit (4)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Relationship to this child (4)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Number of hours this child spends (4)with them each week (4)<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_450_cell1 gform-grid-col' data-label='Name of the person receiving the child benefit (4)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Name of the person receiving the child benefit (4), Row 1' data-aria-label-template='Name of the person receiving the child benefit (4), Row {0}' type='text' name='input_450[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_450_cell2 gform-grid-col' data-label='Relationship to this child (4)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Relationship to this child (4), Row 1' data-aria-label-template='Relationship to this child (4), Row {0}' type='text' name='input_450[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_450_cell3 gform-grid-col' data-label='Number of hours this child spends (4)with them each week (4)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Number of hours this child spends (4)with them each week (4), Row 1' data-aria-label-template='Number of hours this child spends (4)with them each week (4), Row {0}' type='text' name='input_450[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_359\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is this child registered blind? (4)<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_17_359'>\n\t\t\t<div class='gchoice gchoice_17_359_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_359' type='radio' value='Yes'  id='choice_17_359_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_359_0' id='label_17_359_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_17_359_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_359' type='radio' value='No'  id='choice_17_359_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_359_1' id='label_17_359_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_356\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Has this child been formally placed with you for fostering? (4)<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_17_356'>\n\t\t\t<div class='gchoice gchoice_17_356_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_356' type='radio' value='Yes'  id='choice_17_356_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_356_0' id='label_17_356_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_17_356_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_356' type='radio' value='No'  id='choice_17_356_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_356_1' id='label_17_356_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_349\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Does this child receive any benefits for disability such as Personal Independence Payment or Disability Living Allowance? (4)<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_17_349'>\n\t\t\t<div class='gchoice gchoice_17_349_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_349' type='radio' value='Yes'  id='choice_17_349_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_349_0' id='label_17_349_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_17_349_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_349' type='radio' value='No'  id='choice_17_349_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_349_1' id='label_17_349_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_348\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_348'>What benefit(s) does this child receive? (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_348' id='input_17_348' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Personal Independence Payment - daily living and mobility' >Personal Independence Payment &#8211; daily living and mobility<\/option><option value='Personal Independence Payment - daily living only' >Personal Independence Payment &#8211; daily living only<\/option><option value='Personal Independence Payment \u2013 mobility only' >Personal Independence Payment \u2013 mobility only<\/option><option value='Disability Living Allowance - care and mobility components' >Disability Living Allowance &#8211; care and mobility components<\/option><option value='Disability Living Allowance - care component only' >Disability Living Allowance &#8211; care component only<\/option><option value='Disability Living Allowance - mobility component only' >Disability Living Allowance &#8211; mobility component only<\/option><\/select><\/div><\/div><div id=\"field_17_347\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_347'>What is their National Insurance number? (4)<\/label><div class='ginput_container ginput_container_text'><input name='input_347' id='input_17_347' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_280\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is there another child who lives with you? (4)<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_17_280'>\n\t\t\t<div class='gchoice gchoice_17_280_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_280' type='radio' value='Yes'  id='choice_17_280_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_280_0' id='label_17_280_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_17_280_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_280' type='radio' value='No'  id='choice_17_280_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_280_1' id='label_17_280_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_277\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the fifth child<\/h3><\/div><div id=\"field_17_375\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_375'>Full name (child 5)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_375' id='input_17_375' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_373\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date of birth (child 5)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_17_373' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_17_373_2_container'><label for='input_17_373_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_373[]' id='input_17_373_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_17_373_1_container'><label for='input_17_373_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_373[]' id='input_17_373_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_17_373_3_container'><label for='input_17_373_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_373[]' id='input_17_373_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_17_370\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_370'>Gender (child 5)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_370' id='input_17_370' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_366\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner receive Child Benefit for this child?  (5)<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_17_366'>\n\t\t\t<div class='gchoice gchoice_17_366_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_366' type='radio' value='Yes'  id='choice_17_366_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_366_0' id='label_17_366_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_17_366_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_366' type='radio' value='No'  id='choice_17_366_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_366_1' id='label_17_366_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_363\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_363'>How much Child Benefit do you receive for this child? (5)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_363' id='input_17_363' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_453\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you applied for Child Benefit for this child? (5)<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_17_453'>\n\t\t\t<div class='gchoice gchoice_17_453_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_453' type='radio' value='Yes'  id='choice_17_453_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_453_0' id='label_17_453_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_17_453_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_453' type='radio' value='No'  id='choice_17_453_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_453_1' id='label_17_453_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_452\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Who receives child benefit for this child? (5)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name of the person receiving the child benefit (5)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Relationship to this child (5)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Number of hours this child spends with them each week (5)<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_452_cell1 gform-grid-col' data-label='Name of the person receiving the child benefit (5)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Name of the person receiving the child benefit (5), Row 1' data-aria-label-template='Name of the person receiving the child benefit (5), Row {0}' type='text' name='input_452[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_452_cell2 gform-grid-col' data-label='Relationship to this child (5)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Relationship to this child (5), Row 1' data-aria-label-template='Relationship to this child (5), Row {0}' type='text' name='input_452[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_452_cell3 gform-grid-col' data-label='Number of hours this child spends with them each week (5)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Number of hours this child spends with them each week (5), Row 1' data-aria-label-template='Number of hours this child spends with them each week (5), Row {0}' type='text' name='input_452[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_360\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is this child registered blind? (5)<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_17_360'>\n\t\t\t<div class='gchoice gchoice_17_360_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_360' type='radio' value='Yes'  id='choice_17_360_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_360_0' id='label_17_360_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_17_360_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_360' type='radio' value='No'  id='choice_17_360_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_360_1' id='label_17_360_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_357\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Has this child been formally placed with you for fostering? (5)<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_17_357'>\n\t\t\t<div class='gchoice gchoice_17_357_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_357' type='radio' value='Yes'  id='choice_17_357_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_357_0' id='label_17_357_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_17_357_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_357' type='radio' value='No'  id='choice_17_357_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_357_1' id='label_17_357_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_354\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Does this child receive any benefits for disability such as Personal Independence Payment or Disability Living Allowance? (5)<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_17_354'>\n\t\t\t<div class='gchoice gchoice_17_354_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_354' type='radio' value='Yes'  id='choice_17_354_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_354_0' id='label_17_354_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_17_354_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_354' type='radio' value='No'  id='choice_17_354_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_354_1' id='label_17_354_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_352\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_352'>What benefit(s) does this child receive? (5)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_352' id='input_17_352' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Personal Independence Payment - daily living and mobility' >Personal Independence Payment &#8211; daily living and mobility<\/option><option value='Personal Independence Payment - daily living only' >Personal Independence Payment &#8211; daily living only<\/option><option value='Personal Independence Payment \u2013 mobility only' >Personal Independence Payment \u2013 mobility only<\/option><option value='Disability Living Allowance - care and mobility components' >Disability Living Allowance &#8211; care and mobility components<\/option><option value='Disability Living Allowance - care component only' >Disability Living Allowance &#8211; care component only<\/option><option value='Disability Living Allowance - mobility component only' >Disability Living Allowance &#8211; mobility component only<\/option><\/select><\/div><\/div><div id=\"field_17_351\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_351'>What is their National Insurance number? (5)<\/label><div class='ginput_container ginput_container_text'><input name='input_351' id='input_17_351' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_283\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is there another child who lives with you? (5)<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_17_283'>\n\t\t\t<div class='gchoice gchoice_17_283_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_283' type='radio' value='Yes'  id='choice_17_283_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_283_0' id='label_17_283_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_17_283_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_283' type='radio' value='No'  id='choice_17_283_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_283_1' id='label_17_283_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_281\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the sixth child<\/h3><\/div><div id=\"field_17_376\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_376'>Full name (child 6)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_376' id='input_17_376' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_374\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date of birth (child 6)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_17_374' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_17_374_2_container'><label for='input_17_374_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_374[]' id='input_17_374_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_17_374_1_container'><label for='input_17_374_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_374[]' id='input_17_374_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_17_374_3_container'><label for='input_17_374_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_374[]' id='input_17_374_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_17_371\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_371'>Gender (child 6)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_371' id='input_17_371' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_368\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner receive Child Benefit for this child?  (6)<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_17_368'>\n\t\t\t<div class='gchoice gchoice_17_368_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_368' type='radio' value='Yes'  id='choice_17_368_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_368_0' id='label_17_368_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_17_368_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_368' type='radio' value='No'  id='choice_17_368_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_368_1' id='label_17_368_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_364\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_364'>How much Child Benefit do you receive for this child? (6)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_364' id='input_17_364' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_451\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you applied for Child Benefit for this child? (6)<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_17_451'>\n\t\t\t<div class='gchoice gchoice_17_451_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_451' type='radio' value='Yes'  id='choice_17_451_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_451_0' id='label_17_451_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_17_451_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_451' type='radio' value='No'  id='choice_17_451_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_451_1' id='label_17_451_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_467\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Who receives child benefit for this child? (6)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name of the person receiving the child benefit (6)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Relationship to this child (6)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Number of hours this child spends with them each week (6)<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_467_cell1 gform-grid-col' data-label='Name of the person receiving the child benefit (6)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Name of the person receiving the child benefit (6), Row 1' data-aria-label-template='Name of the person receiving the child benefit (6), Row {0}' type='text' name='input_467[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_467_cell2 gform-grid-col' data-label='Relationship to this child (6)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Relationship to this child (6), Row 1' data-aria-label-template='Relationship to this child (6), Row {0}' type='text' name='input_467[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_467_cell3 gform-grid-col' data-label='Number of hours this child spends with them each week (6)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Number of hours this child spends with them each week (6), Row 1' data-aria-label-template='Number of hours this child spends with them each week (6), Row {0}' type='text' name='input_467[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_361\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is this child registered blind? (6)<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_17_361'>\n\t\t\t<div class='gchoice gchoice_17_361_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_361' type='radio' value='Yes'  id='choice_17_361_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_361_0' id='label_17_361_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_17_361_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_361' type='radio' value='No'  id='choice_17_361_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_361_1' id='label_17_361_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_358\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Has this child been formally placed with you for fostering? (6)<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_17_358'>\n\t\t\t<div class='gchoice gchoice_17_358_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_358' type='radio' value='Yes'  id='choice_17_358_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_358_0' id='label_17_358_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_17_358_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_358' type='radio' value='No'  id='choice_17_358_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_358_1' id='label_17_358_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_355\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Does this child receive any benefits for disability such as Personal Independence Payment or Disability Living Allowance? (6)<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_17_355'>\n\t\t\t<div class='gchoice gchoice_17_355_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_355' type='radio' value='Yes'  id='choice_17_355_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_355_0' id='label_17_355_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_17_355_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_355' type='radio' value='No'  id='choice_17_355_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_355_1' id='label_17_355_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_353\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_353'>What benefit(s) does this child receive? (6)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_353' id='input_17_353' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Personal Independence Payment - daily living and mobility' >Personal Independence Payment &#8211; daily living and mobility<\/option><option value='Personal Independence Payment - daily living only' >Personal Independence Payment &#8211; daily living only<\/option><option value='Personal Independence Payment \u2013 mobility only' >Personal Independence Payment \u2013 mobility only<\/option><option value='Disability Living Allowance - care and mobility components' >Disability Living Allowance &#8211; care and mobility components<\/option><option value='Disability Living Allowance - care component only' >Disability Living Allowance &#8211; care component only<\/option><option value='Disability Living Allowance - mobility component only' >Disability Living Allowance &#8211; mobility component only<\/option><\/select><\/div><\/div><div id=\"field_17_350\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_350'>What is their National Insurance number? (6)<\/label><div class='ginput_container ginput_container_text'><input name='input_350' id='input_17_350' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_282\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is there another child who lives with you? 6<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_17_282'>\n\t\t\t<div class='gchoice gchoice_17_282_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_282' type='radio' value='Yes'  id='choice_17_282_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_282_0' id='label_17_282_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_17_282_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_282' type='radio' value='No'  id='choice_17_282_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_282_1' id='label_17_282_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_377\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About any other children<\/h3><div class='gsection_description' id='gfield_description_17_377'>Please provide the following information for any other children who live with you:\n<p><\/p>\n<p><\/p>\n<ul style=\"list-style-type:disc\">\n <li>Full name<\/li>\n <li>Date of birth<\/li>\n<li>Gender<\/li>\n<li>Do you or your partner receive Child Benefit for this child?  If Yes, how much?<\/li>\n<li>Is this child registered blind?<\/li>\n<li>Has this child been formally placed with you for fostering?<\/li>\n<li>Does this child receive any benefits for disability such as Personal Independence Payment or Disability Living Allowance? If Yes, what benefits and what is their National Insurance number?<\/li>\n<\/ul>\n\n<\/div><\/div><div id=\"field_17_378\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_378'>Please  tell us about any other children<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_378' id='input_17_378' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_17_278' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_17_278' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_17_8' class='gform_page' data-js='page-field-id-278' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_17_8' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_17_231\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the other adults who live with you<\/h3><div class='gsection_description' id='gfield_description_17_231'>Please tell us about any other adults who live with you.  An adult is anyone over the age of 16 that you do not receive Child Benefit for.  This includes other family and friends, boarders, subtenants and lodgers.\n<p><\/p>\n<p><\/p>\nInclude any children they have who live in your household.\n<ul style=\"list-style-type:disc\">\n  <li>Tell us about people who are away studying but return for the holidays and after their course.<\/li>\n  <li>Tell us about people who are in the armed forces on operations.<\/li>\n  <li>Don&#8217;t tell us about people who just share a hall, bathroom and\/or toilet<\/li>\n<\/ul><\/div><\/div><div id=\"field_17_299\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the first other adult<\/h3><\/div><div id=\"field_17_290\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_290'>Title (for example Mr, Mrs, Ms, Miss) (adult 1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_290' id='input_17_290' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_291\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_291'>First name (adult 1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_291' id='input_17_291' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_292\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_292'>Last name (adult 1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_292' id='input_17_292' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_296\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date of birth (adult 1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_17_296' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_17_296_2_container'><label for='input_17_296_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_296[]' id='input_17_296_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_17_296_1_container'><label for='input_17_296_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_296[]' id='input_17_296_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_17_296_3_container'><label for='input_17_296_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_296[]' id='input_17_296_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_17_295\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_295'>National Insurance number (adult 1)<\/label><div class='ginput_container ginput_container_text'><input name='input_295' id='input_17_295' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_300\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they a joint owner\/tenant? (adult 1)<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_300'>\n\t\t\t<div class='gchoice gchoice_17_300_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_300' type='radio' value='Yes'  id='choice_17_300_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_300_0' id='label_17_300_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_17_300_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_300' type='radio' value='No'  id='choice_17_300_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_300_1' id='label_17_300_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_301\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_301'>What proportion of the rent\/council do they pay? (adult 1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_17_301'>For example, 25%, half, etc<\/div><div class='ginput_container ginput_container_text'><input name='input_301' id='input_17_301' type='text' value='' class='large'  aria-describedby=\"gfield_description_17_301\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_302\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do they pay rent or money for board and lodgings to you or your partner? (adult 1)<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_17_302'>\n\t\t\t<div class='gchoice gchoice_17_302_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_302' type='radio' value='Yes'  id='choice_17_302_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_302_0' id='label_17_302_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_17_302_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_302' type='radio' value='No'  id='choice_17_302_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_302_1' id='label_17_302_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_303\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Do they receive any of the following? (adult 1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_17_303'>Please select all that apply<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_303'><div class='gchoice gchoice_17_303_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_303.1' type='checkbox'  value='Attendance Allowance'  id='choice_17_303_1'   aria-describedby=\"gfield_description_17_303\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_17_303_1' id='label_17_303_1' class='gform-field-label gform-field-label--type-inline'>Attendance Allowance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_303_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_303.2' type='checkbox'  value='Disability Living Allowance - care component'  id='choice_17_303_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_303_2' id='label_17_303_2' class='gform-field-label gform-field-label--type-inline'>Disability Living Allowance &#8211; care component<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_303_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_303.3' type='checkbox'  value='Personal Independence Payment - daily living component'  id='choice_17_303_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_303_3' id='label_17_303_3' class='gform-field-label gform-field-label--type-inline'>Personal Independence Payment &#8211; daily living component<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_303_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_303.4' type='checkbox'  value='Armed Forces Independence Payment'  id='choice_17_303_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_303_4' id='label_17_303_4' class='gform-field-label gform-field-label--type-inline'>Armed Forces Independence Payment<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_303_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_303.5' type='checkbox'  value='Income Support'  id='choice_17_303_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_303_5' id='label_17_303_5' class='gform-field-label gform-field-label--type-inline'>Income Support<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_303_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_303.6' type='checkbox'  value='Jobseekers Allowance (income based)'  id='choice_17_303_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_303_6' id='label_17_303_6' class='gform-field-label gform-field-label--type-inline'>Jobseekers Allowance (income based)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_303_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_303.7' type='checkbox'  value='Employment and Support Allowance (income related)'  id='choice_17_303_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_303_7' id='label_17_303_7' class='gform-field-label gform-field-label--type-inline'>Employment and Support Allowance (income related)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_303_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_303.8' type='checkbox'  value='Pension Credit (Guarantee Credit)'  id='choice_17_303_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_303_8' id='label_17_303_8' class='gform-field-label gform-field-label--type-inline'>Pension Credit (Guarantee Credit)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_303_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_303.9' type='checkbox'  value='Universal Credit calculated without any earned income'  id='choice_17_303_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_303_9' id='label_17_303_9' class='gform-field-label gform-field-label--type-inline'>Universal Credit calculated without any earned income<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_303_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_303.11' type='checkbox'  value='Universal Credit calculated with earnings'  id='choice_17_303_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_303_11' id='label_17_303_11' class='gform-field-label gform-field-label--type-inline'>Universal Credit calculated with earnings<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_303_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_303.12' type='checkbox'  value='None of the above'  id='choice_17_303_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_303_12' id='label_17_303_12' class='gform-field-label gform-field-label--type-inline'>None of the above<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_304\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do they work? (adult 1)<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_17_304'>\n\t\t\t<div class='gchoice gchoice_17_304_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_304' type='radio' value='Yes'  id='choice_17_304_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_304_0' id='label_17_304_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_17_304_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_304' type='radio' value='No'  id='choice_17_304_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_304_1' id='label_17_304_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_305\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_305'>How many hours per week do they normally work? (adult 1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_305' id='input_17_305' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_429\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_429'>What is their usual gross weekly earnings? (adult 1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_429' id='input_17_429' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_430\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do they receive any other incomes not previously mentioned in addition to their earnings? (adult 1)<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_17_430'>\n\t\t\t<div class='gchoice gchoice_17_430_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_430' type='radio' value='Yes'  id='choice_17_430_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_430_0' id='label_17_430_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_17_430_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_430' type='radio' value='No'  id='choice_17_430_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_430_1' id='label_17_430_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_431\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_431'>Please list the other incomes they receive along with the amount normally received each week (adult 1)<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_431' id='input_17_431' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_17_306\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Do they fall into any of the following categories? (adult 1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_17_306'>Please select all that apply<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_306'><div class='gchoice gchoice_17_306_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_306.1' type='checkbox'  value='Care worker'  id='choice_17_306_1'   aria-describedby=\"gfield_description_17_306\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_17_306_1' id='label_17_306_1' class='gform-field-label gform-field-label--type-inline'>Care worker<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_306_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_306.2' type='checkbox'  value='Apprentice'  id='choice_17_306_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_306_2' id='label_17_306_2' class='gform-field-label gform-field-label--type-inline'>Apprentice<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_306_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_306.3' type='checkbox'  value='Youth trainee'  id='choice_17_306_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_306_3' id='label_17_306_3' class='gform-field-label gform-field-label--type-inline'>Youth trainee<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_306_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_306.4' type='checkbox'  value='Severely mentally impaired'  id='choice_17_306_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_306_4' id='label_17_306_4' class='gform-field-label gform-field-label--type-inline'>Severely mentally impaired<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_306_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_306.5' type='checkbox'  value='In legal custody'  id='choice_17_306_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_306_5' id='label_17_306_5' class='gform-field-label gform-field-label--type-inline'>In legal custody<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_306_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_306.6' type='checkbox'  value='In hospital'  id='choice_17_306_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_306_6' id='label_17_306_6' class='gform-field-label gform-field-label--type-inline'>In hospital<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_306_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_306.7' type='checkbox'  value='None of the above'  id='choice_17_306_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_306_7' id='label_17_306_7' class='gform-field-label gform-field-label--type-inline'>None of the above<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_454\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they a full time student? (adult 1)<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_17_454'>\n\t\t\t<div class='gchoice gchoice_17_454_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_454' type='radio' value='Yes'  id='choice_17_454_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_454_0' id='label_17_454_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_17_454_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_454' type='radio' value='No'  id='choice_17_454_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_454_1' id='label_17_454_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_455\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you already provided a copy of their student certificate?  (adult 1)<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_17_455'>\n\t\t\t<div class='gchoice gchoice_17_455_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_455' type='radio' value='Yes'  id='choice_17_455_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_455_0' id='label_17_455_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_17_455_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_455' type='radio' value='No'  id='choice_17_455_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_455_1' id='label_17_455_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_462\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_17_462'>Upload a copy of their current student certificate  (adult 1)<\/label><div class='gfield_description' id='gfield_description_17_462'>If you do not have it available at the moment you can provide it later. <\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_17_462' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_17_462&quot;,&quot;container&quot;:&quot;gform_multifile_upload_17_462&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_17_462&quot;,&quot;filelist&quot;:&quot;gform_preview_17_462&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/?gf_page=da30025ee0527cd&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;3072000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:17,&quot;field_id&quot;:462,&quot;_gform_file_upload_nonce_17_462&quot;:&quot;a4589e9619&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_17_462&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_17_462' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_17_462' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_17_462 gfield_description_17_462\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_17_462'>Max. file size: 3 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_17_462'><\/ul> <div id='gform_preview_17_462' class='ginput_preview_list'><\/div><\/div><\/div><fieldset id=\"field_17_307\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is there another adult who lives with you? (1)<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_17_307'>\n\t\t\t<div class='gchoice gchoice_17_307_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_307' type='radio' value='Yes'  id='choice_17_307_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_307_0' id='label_17_307_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_17_307_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_307' type='radio' value='No'  id='choice_17_307_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_307_1' id='label_17_307_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_288\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the second adult<\/h3><div class='gsection_description' id='gfield_description_17_288'>\n<\/div><\/div><div id=\"field_17_406\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_406'>Title (for example Mr, Mrs, Ms, Miss) (adult 2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_406' id='input_17_406' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_407\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_407'>First name (adult 2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_407' id='input_17_407' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_408\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_408'>Last name (adult 2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_408' id='input_17_408' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_395\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date of birth (adult 2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_17_395' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_17_395_2_container'><label for='input_17_395_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_395[]' id='input_17_395_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_17_395_1_container'><label for='input_17_395_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_395[]' id='input_17_395_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_17_395_3_container'><label for='input_17_395_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_395[]' id='input_17_395_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_17_401\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_401'>National Insurance number (adult 2)<\/label><div class='ginput_container ginput_container_text'><input name='input_401' id='input_17_401' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_391\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they a joint owner\/tenant? (adult 2)<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_391'>\n\t\t\t<div class='gchoice gchoice_17_391_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_391' type='radio' value='Yes'  id='choice_17_391_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_391_0' id='label_17_391_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_17_391_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_391' type='radio' value='No'  id='choice_17_391_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_391_1' id='label_17_391_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_389\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_389'>What proportion of the rent\/council do they pay? (adult 2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_17_389'>For example, 25%, half, etc<\/div><div class='ginput_container ginput_container_text'><input name='input_389' id='input_17_389' type='text' value='' class='large'  aria-describedby=\"gfield_description_17_389\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_387\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do they pay rent or money for board and lodgings to you or your partner? (adult 2)<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_17_387'>\n\t\t\t<div class='gchoice gchoice_17_387_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_387' type='radio' value='Yes'  id='choice_17_387_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_387_0' id='label_17_387_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_17_387_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_387' type='radio' value='No'  id='choice_17_387_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_387_1' id='label_17_387_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_385\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Do they receive any of the following? (adult 2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_17_385'>Please select all that apply<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_385'><div class='gchoice gchoice_17_385_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_385.1' type='checkbox'  value='Attendance Allowance'  id='choice_17_385_1'   aria-describedby=\"gfield_description_17_385\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_17_385_1' id='label_17_385_1' class='gform-field-label gform-field-label--type-inline'>Attendance Allowance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_385_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_385.2' type='checkbox'  value='Disability Living Allowance - care component'  id='choice_17_385_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_385_2' id='label_17_385_2' class='gform-field-label gform-field-label--type-inline'>Disability Living Allowance &#8211; care component<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_385_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_385.3' type='checkbox'  value='Personal Independence Payment - daily living component'  id='choice_17_385_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_385_3' id='label_17_385_3' class='gform-field-label gform-field-label--type-inline'>Personal Independence Payment &#8211; daily living component<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_385_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_385.4' type='checkbox'  value='Armed Forces Independence Payment'  id='choice_17_385_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_385_4' id='label_17_385_4' class='gform-field-label gform-field-label--type-inline'>Armed Forces Independence Payment<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_385_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_385.5' type='checkbox'  value='Income Support'  id='choice_17_385_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_385_5' id='label_17_385_5' class='gform-field-label gform-field-label--type-inline'>Income Support<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_385_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_385.6' type='checkbox'  value='Jobseekers Allowance (income based)'  id='choice_17_385_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_385_6' id='label_17_385_6' class='gform-field-label gform-field-label--type-inline'>Jobseekers Allowance (income based)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_385_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_385.7' type='checkbox'  value='Employment and Support Allowance (income related)'  id='choice_17_385_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_385_7' id='label_17_385_7' class='gform-field-label gform-field-label--type-inline'>Employment and Support Allowance (income related)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_385_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_385.8' type='checkbox'  value='Pension Credit (Guarantee Credit)'  id='choice_17_385_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_385_8' id='label_17_385_8' class='gform-field-label gform-field-label--type-inline'>Pension Credit (Guarantee Credit)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_385_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_385.9' type='checkbox'  value='Universal Credit calculated without any earned income'  id='choice_17_385_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_385_9' id='label_17_385_9' class='gform-field-label gform-field-label--type-inline'>Universal Credit calculated without any earned income<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_385_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_385.11' type='checkbox'  value='Universal Credit calculated with earnings'  id='choice_17_385_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_385_11' id='label_17_385_11' class='gform-field-label gform-field-label--type-inline'>Universal Credit calculated with earnings<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_385_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_385.12' type='checkbox'  value='None of the above'  id='choice_17_385_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_385_12' id='label_17_385_12' class='gform-field-label gform-field-label--type-inline'>None of the above<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_383\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do they work? (adult 2)<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_17_383'>\n\t\t\t<div class='gchoice gchoice_17_383_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_383' type='radio' value='Yes'  id='choice_17_383_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_383_0' id='label_17_383_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_17_383_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_383' type='radio' value='No'  id='choice_17_383_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_383_1' id='label_17_383_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_381\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_381'>How many hours per week do they normally work? (adult 2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_381' id='input_17_381' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_432\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_432'>What is their usual gross weekly earnings? (adult 2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_432' id='input_17_432' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_433\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do they receive any other incomes not previously mentioned in addition to their earnings? (adult 2)<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_17_433'>\n\t\t\t<div class='gchoice gchoice_17_433_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_433' type='radio' value='Yes'  id='choice_17_433_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_433_0' id='label_17_433_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_17_433_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_433' type='radio' value='No'  id='choice_17_433_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_433_1' id='label_17_433_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_434\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_434'>Please list the other incomes they receive along with the amount normally received each week (adult 2)<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_434' id='input_17_434' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_17_379\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Do they fall into any of the following categories? (adult 2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_17_379'>Please select all that apply<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_379'><div class='gchoice gchoice_17_379_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_379.1' type='checkbox'  value='Care worker'  id='choice_17_379_1'   aria-describedby=\"gfield_description_17_379\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_17_379_1' id='label_17_379_1' class='gform-field-label gform-field-label--type-inline'>Care worker<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_379_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_379.2' type='checkbox'  value='Apprentice'  id='choice_17_379_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_379_2' id='label_17_379_2' class='gform-field-label gform-field-label--type-inline'>Apprentice<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_379_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_379.3' type='checkbox'  value='Youth trainee'  id='choice_17_379_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_379_3' id='label_17_379_3' class='gform-field-label gform-field-label--type-inline'>Youth trainee<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_379_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_379.4' type='checkbox'  value='Severely mentally impaired'  id='choice_17_379_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_379_4' id='label_17_379_4' class='gform-field-label gform-field-label--type-inline'>Severely mentally impaired<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_379_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_379.5' type='checkbox'  value='In legal custody'  id='choice_17_379_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_379_5' id='label_17_379_5' class='gform-field-label gform-field-label--type-inline'>In legal custody<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_379_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_379.6' type='checkbox'  value='In hospital'  id='choice_17_379_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_379_6' id='label_17_379_6' class='gform-field-label gform-field-label--type-inline'>In hospital<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_379_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_379.7' type='checkbox'  value='None of the above'  id='choice_17_379_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_379_7' id='label_17_379_7' class='gform-field-label gform-field-label--type-inline'>None of the above<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_456\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they a full time student? (adult 2)<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_17_456'>\n\t\t\t<div class='gchoice gchoice_17_456_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_456' type='radio' value='Yes'  id='choice_17_456_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_456_0' id='label_17_456_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_17_456_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_456' type='radio' value='No'  id='choice_17_456_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_456_1' id='label_17_456_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_459\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you already provided a copy of their student certificate?  (adult 2)<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_17_459'>\n\t\t\t<div class='gchoice gchoice_17_459_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_459' type='radio' value='Yes'  id='choice_17_459_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_459_0' id='label_17_459_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_17_459_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_459' type='radio' value='No'  id='choice_17_459_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_459_1' id='label_17_459_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_464\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_17_464'>Upload a copy of their current student certificate (adult 2)<\/label><div class='gfield_description' id='gfield_description_17_464'>If you do not have it available at the moment you can provide it later. <\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_17_464' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_17_464&quot;,&quot;container&quot;:&quot;gform_multifile_upload_17_464&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_17_464&quot;,&quot;filelist&quot;:&quot;gform_preview_17_464&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/?gf_page=da30025ee0527cd&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;3072000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:17,&quot;field_id&quot;:464,&quot;_gform_file_upload_nonce_17_464&quot;:&quot;1c3625f309&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_17_464&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_17_464' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_17_464' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_17_464 gfield_description_17_464\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_17_464'>Max. file size: 3 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_17_464'><\/ul> <div id='gform_preview_17_464' class='ginput_preview_list'><\/div><\/div><\/div><fieldset id=\"field_17_308\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is there another adult who lives with you? (2)<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_17_308'>\n\t\t\t<div class='gchoice gchoice_17_308_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_308' type='radio' value='Yes'  id='choice_17_308_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_308_0' id='label_17_308_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_17_308_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_308' type='radio' value='No'  id='choice_17_308_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_308_1' id='label_17_308_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_287\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the third adult<\/h3><\/div><div id=\"field_17_409\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_409'>Title (for example Mr, Mrs, Ms, Miss) (adult 3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_409' id='input_17_409' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_411\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_411'>First name (adult 3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_411' id='input_17_411' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_410\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_410'>Last name (adult 3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_410' id='input_17_410' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_398\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date of birth (adult 3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_17_398' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_17_398_2_container'><label for='input_17_398_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_398[]' id='input_17_398_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_17_398_1_container'><label for='input_17_398_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_398[]' id='input_17_398_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_17_398_3_container'><label for='input_17_398_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_398[]' id='input_17_398_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_17_399\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_399'>National Insurance number (adult 3)<\/label><div class='ginput_container ginput_container_text'><input name='input_399' id='input_17_399' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_392\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they a joint owner\/tenant? (adult 3)<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_392'>\n\t\t\t<div class='gchoice gchoice_17_392_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_392' type='radio' value='Yes'  id='choice_17_392_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_392_0' id='label_17_392_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_17_392_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_392' type='radio' value='No'  id='choice_17_392_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_392_1' id='label_17_392_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_390\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_390'>What proportion of the rent\/council do they pay? (adult 3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_17_390'>For example, 25%, half, etc<\/div><div class='ginput_container ginput_container_text'><input name='input_390' id='input_17_390' type='text' value='' class='large'  aria-describedby=\"gfield_description_17_390\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_388\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do they pay rent or money for board and lodgings to you or your partner? (adult 3)<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_17_388'>\n\t\t\t<div class='gchoice gchoice_17_388_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_388' type='radio' value='Yes'  id='choice_17_388_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_388_0' id='label_17_388_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_17_388_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_388' type='radio' value='No'  id='choice_17_388_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_388_1' id='label_17_388_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_386\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Do they receive any of the following? (adult 3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_17_386'>Please select all that apply<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_386'><div class='gchoice gchoice_17_386_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_386.1' type='checkbox'  value='Attendance Allowance'  id='choice_17_386_1'   aria-describedby=\"gfield_description_17_386\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_17_386_1' id='label_17_386_1' class='gform-field-label gform-field-label--type-inline'>Attendance Allowance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_386_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_386.2' type='checkbox'  value='Disability Living Allowance - care component'  id='choice_17_386_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_386_2' id='label_17_386_2' class='gform-field-label gform-field-label--type-inline'>Disability Living Allowance &#8211; care component<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_386_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_386.3' type='checkbox'  value='Personal Independence Payment - daily living component'  id='choice_17_386_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_386_3' id='label_17_386_3' class='gform-field-label gform-field-label--type-inline'>Personal Independence Payment &#8211; daily living component<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_386_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_386.4' type='checkbox'  value='Armed Forces Independence Payment'  id='choice_17_386_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_386_4' id='label_17_386_4' class='gform-field-label gform-field-label--type-inline'>Armed Forces Independence Payment<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_386_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_386.5' type='checkbox'  value='Income Support'  id='choice_17_386_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_386_5' id='label_17_386_5' class='gform-field-label gform-field-label--type-inline'>Income Support<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_386_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_386.6' type='checkbox'  value='Jobseekers Allowance (income based)'  id='choice_17_386_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_386_6' id='label_17_386_6' class='gform-field-label gform-field-label--type-inline'>Jobseekers Allowance (income based)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_386_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_386.7' type='checkbox'  value='Employment and Support Allowance (income related)'  id='choice_17_386_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_386_7' id='label_17_386_7' class='gform-field-label gform-field-label--type-inline'>Employment and Support Allowance (income related)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_386_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_386.8' type='checkbox'  value='Pension Credit (Guarantee Credit)'  id='choice_17_386_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_386_8' id='label_17_386_8' class='gform-field-label gform-field-label--type-inline'>Pension Credit (Guarantee Credit)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_386_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_386.9' type='checkbox'  value='Universal Credit calculated without any earned income'  id='choice_17_386_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_386_9' id='label_17_386_9' class='gform-field-label gform-field-label--type-inline'>Universal Credit calculated without any earned income<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_386_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_386.11' type='checkbox'  value='Universal Credit calculated with earnings'  id='choice_17_386_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_386_11' id='label_17_386_11' class='gform-field-label gform-field-label--type-inline'>Universal Credit calculated with earnings<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_386_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_386.12' type='checkbox'  value='None of the above'  id='choice_17_386_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_386_12' id='label_17_386_12' class='gform-field-label gform-field-label--type-inline'>None of the above<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_384\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do they work? (adult 3)<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_17_384'>\n\t\t\t<div class='gchoice gchoice_17_384_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_384' type='radio' value='Yes'  id='choice_17_384_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_384_0' id='label_17_384_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_17_384_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_384' type='radio' value='No'  id='choice_17_384_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_384_1' id='label_17_384_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_382\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_382'>How many hours per week do they normally work? (adult 3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_382' id='input_17_382' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_435\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_435'>What is their usual gross weekly earnings? (adult 3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_435' id='input_17_435' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_436\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do they receive any other incomes not previously mentioned in addition to their earnings? (adult 3)<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_17_436'>\n\t\t\t<div class='gchoice gchoice_17_436_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_436' type='radio' value='Yes'  id='choice_17_436_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_436_0' id='label_17_436_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_17_436_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_436' type='radio' value='No'  id='choice_17_436_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_436_1' id='label_17_436_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_437\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_437'>Please list the other incomes they receive along with the amount normally received each week (adult 3)<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_437' id='input_17_437' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_17_380\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Do they fall into any of the following categories? (adult 3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_17_380'>Please select all that apply<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_380'><div class='gchoice gchoice_17_380_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_380.1' type='checkbox'  value='Care worker'  id='choice_17_380_1'   aria-describedby=\"gfield_description_17_380\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_17_380_1' id='label_17_380_1' class='gform-field-label gform-field-label--type-inline'>Care worker<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_380_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_380.2' type='checkbox'  value='Apprentice'  id='choice_17_380_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_380_2' id='label_17_380_2' class='gform-field-label gform-field-label--type-inline'>Apprentice<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_380_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_380.3' type='checkbox'  value='Youth trainee'  id='choice_17_380_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_380_3' id='label_17_380_3' class='gform-field-label gform-field-label--type-inline'>Youth trainee<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_380_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_380.4' type='checkbox'  value='Severely mentally impaired'  id='choice_17_380_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_380_4' id='label_17_380_4' class='gform-field-label gform-field-label--type-inline'>Severely mentally impaired<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_380_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_380.5' type='checkbox'  value='In legal custody'  id='choice_17_380_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_380_5' id='label_17_380_5' class='gform-field-label gform-field-label--type-inline'>In legal custody<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_380_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_380.6' type='checkbox'  value='In hospital'  id='choice_17_380_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_380_6' id='label_17_380_6' class='gform-field-label gform-field-label--type-inline'>In hospital<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_380_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_380.7' type='checkbox'  value='None of the above'  id='choice_17_380_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_380_7' id='label_17_380_7' class='gform-field-label gform-field-label--type-inline'>None of the above<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_457\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they a full time student? (adult 3)<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_17_457'>\n\t\t\t<div class='gchoice gchoice_17_457_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_457' type='radio' value='Yes'  id='choice_17_457_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_457_0' id='label_17_457_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_17_457_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_457' type='radio' value='No'  id='choice_17_457_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_457_1' id='label_17_457_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_460\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you already provided a copy of their student certificate?  (adult 3)<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_17_460'>\n\t\t\t<div class='gchoice gchoice_17_460_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_460' type='radio' value='Yes'  id='choice_17_460_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_460_0' id='label_17_460_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_17_460_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_460' type='radio' value='No'  id='choice_17_460_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_460_1' id='label_17_460_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_463\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_17_463'>Upload a copy of their current student certificate (adult 3)<\/label><div class='gfield_description' id='gfield_description_17_463'>If you do not have it available at the moment you can provide it later. <\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_17_463' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_17_463&quot;,&quot;container&quot;:&quot;gform_multifile_upload_17_463&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_17_463&quot;,&quot;filelist&quot;:&quot;gform_preview_17_463&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/?gf_page=da30025ee0527cd&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;3072000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:17,&quot;field_id&quot;:463,&quot;_gform_file_upload_nonce_17_463&quot;:&quot;b5e8eebb1e&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_17_463&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_17_463' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_17_463' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_17_463 gfield_description_17_463\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_17_463'>Max. file size: 3 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_17_463'><\/ul> <div id='gform_preview_17_463' class='ginput_preview_list'><\/div><\/div><\/div><fieldset id=\"field_17_309\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is there another adult who lives with you? (3)<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_17_309'>\n\t\t\t<div class='gchoice gchoice_17_309_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_309' type='radio' value='Yes'  id='choice_17_309_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_309_0' id='label_17_309_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_17_309_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_309' type='radio' value='No'  id='choice_17_309_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_309_1' id='label_17_309_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_415\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the fourth adult<\/h3><\/div><div id=\"field_17_427\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_427'>Title (for example Mr, Mrs, Ms, Miss) (adult 4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_427' id='input_17_427' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_426\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_426'>First name (adult 4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_426' id='input_17_426' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_428\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_428'>Last name (adult 4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_428' id='input_17_428' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_425\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date of birth (adult 4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_17_425' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_17_425_2_container'><label for='input_17_425_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_425[]' id='input_17_425_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_17_425_1_container'><label for='input_17_425_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_425[]' id='input_17_425_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_17_425_3_container'><label for='input_17_425_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_425[]' id='input_17_425_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_17_424\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_424'>National Insurance number (adult 4)<\/label><div class='ginput_container ginput_container_text'><input name='input_424' id='input_17_424' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_423\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they a joint owner\/tenant? (adult 4)<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_423'>\n\t\t\t<div class='gchoice gchoice_17_423_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_423' type='radio' value='Yes'  id='choice_17_423_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_423_0' id='label_17_423_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_17_423_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_423' type='radio' value='No'  id='choice_17_423_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_423_1' id='label_17_423_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_422\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_422'>What proportion of the rent\/council do they pay? (adult 4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_17_422'>For example, 25%, half, etc<\/div><div class='ginput_container ginput_container_text'><input name='input_422' id='input_17_422' type='text' value='' class='large'  aria-describedby=\"gfield_description_17_422\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_421\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do they pay rent or money for board and lodgings to you or your partner? (adult 4)<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_17_421'>\n\t\t\t<div class='gchoice gchoice_17_421_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_421' type='radio' value='Yes'  id='choice_17_421_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_421_0' id='label_17_421_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_17_421_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_421' type='radio' value='No'  id='choice_17_421_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_421_1' id='label_17_421_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_420\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Do they receive any of the following? (adult 4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_17_420'>Please select all that apply<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_420'><div class='gchoice gchoice_17_420_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_420.1' type='checkbox'  value='Attendance Allowance'  id='choice_17_420_1'   aria-describedby=\"gfield_description_17_420\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_17_420_1' id='label_17_420_1' class='gform-field-label gform-field-label--type-inline'>Attendance Allowance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_420_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_420.2' type='checkbox'  value='Disability Living Allowance - care component'  id='choice_17_420_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_420_2' id='label_17_420_2' class='gform-field-label gform-field-label--type-inline'>Disability Living Allowance &#8211; care component<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_420_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_420.3' type='checkbox'  value='Personal Independence Payment - daily living component'  id='choice_17_420_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_420_3' id='label_17_420_3' class='gform-field-label gform-field-label--type-inline'>Personal Independence Payment &#8211; daily living component<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_420_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_420.4' type='checkbox'  value='Armed Forces Independence Payment'  id='choice_17_420_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_420_4' id='label_17_420_4' class='gform-field-label gform-field-label--type-inline'>Armed Forces Independence Payment<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_420_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_420.5' type='checkbox'  value='Income Support'  id='choice_17_420_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_420_5' id='label_17_420_5' class='gform-field-label gform-field-label--type-inline'>Income Support<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_420_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_420.6' type='checkbox'  value='Jobseekers Allowance (income based)'  id='choice_17_420_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_420_6' id='label_17_420_6' class='gform-field-label gform-field-label--type-inline'>Jobseekers Allowance (income based)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_420_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_420.7' type='checkbox'  value='Employment and Support Allowance (income related)'  id='choice_17_420_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_420_7' id='label_17_420_7' class='gform-field-label gform-field-label--type-inline'>Employment and Support Allowance (income related)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_420_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_420.8' type='checkbox'  value='Pension Credit (Guarantee Credit)'  id='choice_17_420_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_420_8' id='label_17_420_8' class='gform-field-label gform-field-label--type-inline'>Pension Credit (Guarantee Credit)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_420_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_420.9' type='checkbox'  value='Universal Credit calculated without any earned income'  id='choice_17_420_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_420_9' id='label_17_420_9' class='gform-field-label gform-field-label--type-inline'>Universal Credit calculated without any earned income<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_420_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_420.11' type='checkbox'  value='Universal Credit calculated with earnings'  id='choice_17_420_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_420_11' id='label_17_420_11' class='gform-field-label gform-field-label--type-inline'>Universal Credit calculated with earnings<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_420_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_420.12' type='checkbox'  value='None of the above'  id='choice_17_420_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_420_12' id='label_17_420_12' class='gform-field-label gform-field-label--type-inline'>None of the above<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_419\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do they work? (adult 4)<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_17_419'>\n\t\t\t<div class='gchoice gchoice_17_419_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_419' type='radio' value='Yes'  id='choice_17_419_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_419_0' id='label_17_419_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_17_419_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_419' type='radio' value='No'  id='choice_17_419_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_419_1' id='label_17_419_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_418\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_418'>How many hours per week do they normally work? (adult 4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_418' id='input_17_418' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_438\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_438'>What is their usual gross weekly earnings? (adult 4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_438' id='input_17_438' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_439\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do they receive any other incomes not previously mentioned in addition to their earnings? (adult 4)<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_17_439'>\n\t\t\t<div class='gchoice gchoice_17_439_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_439' type='radio' value='Yes'  id='choice_17_439_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_439_0' id='label_17_439_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_17_439_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_439' type='radio' value='No'  id='choice_17_439_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_439_1' id='label_17_439_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_440\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_440'>Please list the other incomes they receive along with the amount normally received each week (adult 4)<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_440' id='input_17_440' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_17_417\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Do they fall into any of the following categories? (adult 4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_17_417'>Please select all that apply<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_417'><div class='gchoice gchoice_17_417_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_417.1' type='checkbox'  value='Care worker'  id='choice_17_417_1'   aria-describedby=\"gfield_description_17_417\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_17_417_1' id='label_17_417_1' class='gform-field-label gform-field-label--type-inline'>Care worker<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_417_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_417.2' type='checkbox'  value='Apprentice'  id='choice_17_417_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_417_2' id='label_17_417_2' class='gform-field-label gform-field-label--type-inline'>Apprentice<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_417_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_417.3' type='checkbox'  value='Youth trainee'  id='choice_17_417_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_417_3' id='label_17_417_3' class='gform-field-label gform-field-label--type-inline'>Youth trainee<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_417_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_417.4' type='checkbox'  value='Severely mentally impaired'  id='choice_17_417_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_417_4' id='label_17_417_4' class='gform-field-label gform-field-label--type-inline'>Severely mentally impaired<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_417_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_417.5' type='checkbox'  value='In legal custody'  id='choice_17_417_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_417_5' id='label_17_417_5' class='gform-field-label gform-field-label--type-inline'>In legal custody<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_417_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_417.6' type='checkbox'  value='In hospital'  id='choice_17_417_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_417_6' id='label_17_417_6' class='gform-field-label gform-field-label--type-inline'>In hospital<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_417_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_417.7' type='checkbox'  value='None of the above'  id='choice_17_417_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_417_7' id='label_17_417_7' class='gform-field-label gform-field-label--type-inline'>None of the above<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_458\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they a full time student? (adult 4)<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_17_458'>\n\t\t\t<div class='gchoice gchoice_17_458_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_458' type='radio' value='Yes'  id='choice_17_458_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_458_0' id='label_17_458_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_17_458_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_458' type='radio' value='No'  id='choice_17_458_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_458_1' id='label_17_458_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_461\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you already provided a copy of their student certificate?  (adult 4)<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_17_461'>\n\t\t\t<div class='gchoice gchoice_17_461_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_461' type='radio' value='Yes'  id='choice_17_461_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_461_0' id='label_17_461_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_17_461_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_461' type='radio' value='No'  id='choice_17_461_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_461_1' id='label_17_461_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_465\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_17_465'>Upload a copy of their current student certificate (adult 4)<\/label><div class='gfield_description' id='gfield_description_17_465'>If you do not have it available at the moment you can provide it later. <\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_17_465' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_17_465&quot;,&quot;container&quot;:&quot;gform_multifile_upload_17_465&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_17_465&quot;,&quot;filelist&quot;:&quot;gform_preview_17_465&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/?gf_page=da30025ee0527cd&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;3072000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:17,&quot;field_id&quot;:465,&quot;_gform_file_upload_nonce_17_465&quot;:&quot;e3da2b9d7d&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_17_465&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_17_465' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_17_465' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_17_465 gfield_description_17_465\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_17_465'>Max. file size: 3 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_17_465'><\/ul> <div id='gform_preview_17_465' class='ginput_preview_list'><\/div><\/div><\/div><fieldset id=\"field_17_416\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is there another adult who lives with you? (4)<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_17_416'>\n\t\t\t<div class='gchoice gchoice_17_416_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_416' type='radio' value='Yes'  id='choice_17_416_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_416_0' id='label_17_416_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_17_416_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_416' type='radio' value='No'  id='choice_17_416_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_416_1' id='label_17_416_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_412\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About any other adults who live with you<\/h3><div class='gsection_description' id='gfield_description_17_412'>Please provide the following information for any other adults who live with you:\n<p><\/p>\n<p><\/p>\n<ul style=\"list-style-type:disc\">\n <li>Full name<\/li>\n  <li>Date of birth<\/li>\n<li>National Insurance number<\/li>\n<li>Are they a joint owner\/tenant? if Yes what proportion of the rent\/council do they pay?<\/li>\n<li>Do they pay rent or money for board and lodgings to you or your partner?<\/li>\n<li>Do they receive any Allowance or  Independence payments?<\/li>\n<li>Do they work?  If Yes, how many hours?<\/li>\n<li>Are they a: Full time student, care worker, apprentice, youth trainee severely mentally impaired, in legal custody or in hospital?<\/li>\n<\/ul><\/div><\/div><div id=\"field_17_413\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_413'>Please  tell us about any other adults<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_413' id='input_17_413' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_17_468\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About any other people who live with you (continued)<\/h3><\/div><fieldset id=\"field_17_469\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do any of the other people listed live together as a couple?<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_17_469'>\n\t\t\t<div class='gchoice gchoice_17_469_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_469' type='radio' value='Yes'  id='choice_17_469_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_469_0' id='label_17_469_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_17_469_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_469' type='radio' value='No'  id='choice_17_469_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_469_1' id='label_17_469_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_470\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Please tell us the full names of the couples<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_17_470'>Enter the information and then click on the + sign to add another row for each couple.<\/div><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Full name &#8211; is the partner of<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Full name<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_470_cell1 gform-grid-col' data-label='Full name - is the partner of'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_17_470\" aria-label='Full name - is the partner of, Row 1' data-aria-label-template='Full name - is the partner of, Row {0}' type='text' name='input_470[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_470_cell2 gform-grid-col' data-label='Full name'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_17_470\" aria-label='Full name, Row 1' data-aria-label-template='Full name, Row {0}' type='text' name='input_470[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_17_155' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_17_155' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_17_9' class='gform_page' data-js='page-field-id-155' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_17_9' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_17_317\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About any other benefits you (or your partner if you have one) receive<\/h3><div class='gsection_description' id='gfield_description_17_317'>As you are on Universal Credit we only need to know about certain benefits.<\/div><\/div><fieldset id=\"field_17_85\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you (or your partner if you have one) receive Attendance Allowance?<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_17_85'>\n\t\t\t<div class='gchoice gchoice_17_85_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_85' type='radio' value='Yes, I receive Attendance Allowance'  id='choice_17_85_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_85_0' id='label_17_85_0' class='gform-field-label gform-field-label--type-inline'>Yes, I receive Attendance Allowance<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_85_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_85' type='radio' value='Yes, my partner receives Attendance Allowance'  id='choice_17_85_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_85_1' id='label_17_85_1' class='gform-field-label gform-field-label--type-inline'>Yes, my partner receives Attendance Allowance<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_85_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_85' type='radio' value='Yes, we both receive Attendance Allowance'  id='choice_17_85_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_85_2' id='label_17_85_2' class='gform-field-label gform-field-label--type-inline'>Yes, we both receive Attendance Allowance<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_85_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_85' type='radio' value='No'  id='choice_17_85_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_85_3' id='label_17_85_3' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_318\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you (or your partner if you have one) receive Disability Living Allowance?<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_17_318'>\n\t\t\t<div class='gchoice gchoice_17_318_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_318' type='radio' value='Yes, I receive Disability Living Allowance'  id='choice_17_318_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_318_0' id='label_17_318_0' class='gform-field-label gform-field-label--type-inline'>Yes, I receive Disability Living Allowance<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_318_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_318' type='radio' value='Yes, my partner receives Disability Living Allowance'  id='choice_17_318_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_318_1' id='label_17_318_1' class='gform-field-label gform-field-label--type-inline'>Yes, my partner receives Disability Living Allowance<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_318_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_318' type='radio' value='Yes, we both receive Disability Living Allowance'  id='choice_17_318_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_318_2' id='label_17_318_2' class='gform-field-label gform-field-label--type-inline'>Yes, we both receive Disability Living Allowance<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_318_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_318' type='radio' value='No'  id='choice_17_318_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_318_3' id='label_17_318_3' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_319\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you (or your partner if you have one) receive Personal Independence Payment (or Armed Forces Independence Payment)?<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_17_319'>\n\t\t\t<div class='gchoice gchoice_17_319_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_319' type='radio' value='Yes, I receive Personal Independence Payment (or Armed Forces Independence Payment)'  id='choice_17_319_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_319_0' id='label_17_319_0' class='gform-field-label gform-field-label--type-inline'>Yes, I receive Personal Independence Payment (or Armed Forces Independence Payment)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_319_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_319' type='radio' value='Yes, my partner receives Personal Independence Payment (or Armed Forces Independence Payment)'  id='choice_17_319_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_319_1' id='label_17_319_1' class='gform-field-label gform-field-label--type-inline'>Yes, my partner receives Personal Independence Payment (or Armed Forces Independence Payment)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_319_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_319' type='radio' value='Yes, we both receive Personal Independence Payment (or Armed Forces Independence Payment)'  id='choice_17_319_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_319_2' id='label_17_319_2' class='gform-field-label gform-field-label--type-inline'>Yes, we both receive Personal Independence Payment (or Armed Forces Independence Payment)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_319_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_319' type='radio' value='No'  id='choice_17_319_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_319_3' id='label_17_319_3' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_17_165' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_17_165' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_17_10' class='gform_page' data-js='page-field-id-165' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_17_10' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_17_164\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the proof you need to provide<\/h3><div class='gsection_description' id='gfield_description_17_164'>You need to provide proof to support your application.  If you can&#8217;t submit all your proof now, you can still submit this form and send your proof to us within one calendar month from the day the form is submitted. We&#8217;ll tell you how to do that in the email confirmation.<\/p>\n\n<h3>Proof you need to upload<\/h3>\n\n<h4>Proof of identity<\/h4>\n<p>Evidence can include birth certificate, marriage certificate, passport, medical card,\ndriving licence, UK residence permit, EU National Identity card, recent gas or electricity bill.\n\n<h4>Proof of National Insurance Number<\/h4>\n<p>Evidence can include: National Insurance card, Department for Work and Pensions (DWP) letter, wage slip, P45\/P60, pension letter, Tax Credit award letter.<\/p>\n\n<h4>Proof of other adults&#8217; income<\/h4>\n<p>Evidence can include: Proof of Income Support, Jobseekers Allowance (Income Based), Employment and Support\nAllowance (Income Related), Pension Credit or Universal Credit.<\/p>\n\n\n<\/div><\/div><fieldset id=\"field_17_324\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Will you upload your proof now or within one calendar month?<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_17_324'>\n\t\t\t<div class='gchoice gchoice_17_324_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_324' type='radio' value='I will upload my proof to this form now'  id='choice_17_324_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_324_0' id='label_17_324_0' class='gform-field-label gform-field-label--type-inline'>I will upload my proof to this form now<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_324_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_324' type='radio' value='I can&#039;t upload my proof to this form now, I&#039;ll send it within one calendar month'  id='choice_17_324_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_324_1' id='label_17_324_1' class='gform-field-label gform-field-label--type-inline'>I can&#8217;t upload my proof to this form now, I&#8217;ll send it within one calendar month<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_166\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_17_166'>Please upload proof of any documents we need to see:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_17_166'>If you are uploading photographs of documents, please make sure you take a photo of every relevant page, that they are clear and that any words or figures can be easily read.  Max 10 uploads, each document should be no bigger than 2MB<\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_17_166' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_17_166&quot;,&quot;container&quot;:&quot;gform_multifile_upload_17_166&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_17_166&quot;,&quot;filelist&quot;:&quot;gform_preview_17_166&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/?gf_page=da30025ee0527cd&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;20971520b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:17,&quot;field_id&quot;:166,&quot;_gform_file_upload_nonce_17_166&quot;:&quot;b6f856b386&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;10&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_17_166&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_17_166' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_17_166' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_17_166 gfield_description_17_166\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_17_166'>Max. file size: 20 MB, Max. files: 10.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_17_166'><\/ul> <div id='gform_preview_17_166' class='ginput_preview_list'><\/div><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_17_316' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_17_316' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_17_11' class='gform_page' data-js='page-field-id-316' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_17_11' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_17_320\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Backdating your claim<\/h3><div class='gsection_description' id='gfield_description_17_320'>Your award can be backdated up to 3 months if your circumstances qualify you for Council\nTax Support.<p><\/p>\n\nIf you were not entitled to Universal Credit for this earlier period we may need to ask for\nfurther evidence to allow us to assess any entitlement.<p><\/p>\n\nCouncil Tax Support will normally begin from the Monday following the date you want to claim from if it is within the last three months. <p><\/p>\n\nIf you leave this date blank we will either treat your claim as being from the date this form was submitted, or we will consider awarding up to three months backdating if you were entitled to Universal Credit during that period.<\/div><\/div><fieldset id=\"field_17_321\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >What date would you like your award to be considered from?<\/legend><div id='input_17_321' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_17_321_2_container'><label for='input_17_321_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_321[]' id='input_17_321_2'   aria-required='false'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_17_321_1_container'><label for='input_17_321_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_321[]' id='input_17_321_1'   aria-required='false'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_17_321_3_container'><label for='input_17_321_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_321[]' id='input_17_321_3'   aria-required='false'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_17_322\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_17_153\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About any other information<\/h3><div class='gsection_description' id='gfield_description_17_153'>If there is any information you want to tell us about that hasn\u2019t been covered previously, or additional information you want to provide to support your claim tell us below.\n<\/div><\/div><div id=\"field_17_154\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_154'>Other information<\/label><div class='gfield_description' id='gfield_description_17_154'>If you have no further information to give, leave this box blank<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_154' id='input_17_154' class='textarea medium'  aria-describedby=\"gfield_description_17_154\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><input type='submit' id='gform_previous_button_17' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='submit' id='gform_submit_button_17' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Submit'  \/> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_17' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_17' id='gform_theme_17' value='orbital' \/>\n            <input 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