{"id":1065,"date":"2021-04-02T14:44:11","date_gmt":"2021-04-02T14:44:11","guid":{"rendered":"https:\/\/www.togusainc.com\/?page_id=1065"},"modified":"2021-04-02T17:01:49","modified_gmt":"2021-04-02T17:01:49","slug":"new-customer","status":"publish","type":"page","link":"https:\/\/www.togusainc.com\/new-customer\/","title":{"rendered":"New Customer"},"content":{"rendered":"\n<div class=\"wp-block-genesis-blocks-gb-accordion gb-block-accordion\"><details><summary class=\"gb-accordion-title\">New Customer Form<\/summary><div class=\"gb-accordion-text\"> \n    <script type=\"text\/javascript\">\n        jQuery(document).ready(function(){\n            \/* apply only to a input with a class of gf_readonly *\/\n            jQuery(\"li.gf_readonly input\").attr(\"readonly\",\"readonly\");\n        });\n    <\/script>\n \n    <script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_chrome gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_2' style='display:none'>\n                        <div class='gform_heading'>\n                            <h3 class=\"gform_title\">New Customer Form<\/h3>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_2'  action='\/wp-json\/wp\/v2\/pages\/1065' data-formid='2' >\n                        <div class='gform-body gform_body'><ul id='gform_fields_2' class='gform_fields top_label form_sublabel_below description_below'><li id=\"field_2_1\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_1\"><label class='gfield_label gform-field-label' for='input_2_1' >Business Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_2_1' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_2\"  class=\"gfield gfield--type-address gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_2\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_2_2' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_2_2_1_container' >\n                                        <input type='text' name='input_2.1' id='input_2_2_1' value=''    aria-required='true'    \/>\n                                        <label for='input_2_2_1' id='input_2_2_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_2_2_2_container' >\n                                        <input type='text' name='input_2.2' id='input_2_2_2' value=''     aria-required='false'   \/>\n                                        <label for='input_2_2_2' id='input_2_2_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_2_2_3_container' >\n                                    <input type='text' name='input_2.3' id='input_2_2_3' value=''    aria-required='true'    \/>\n                                    <label for='input_2_2_3' id='input_2_2_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_2_2_4_container' >\n                                        <select name='input_2.4' id='input_2_2_4'     aria-required='true'    ><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_2_2_4' id='input_2_2_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_2_2_5_container' >\n                                    <input type='text' name='input_2.5' id='input_2_2_5' value=''    aria-required='true'    \/>\n                                    <label for='input_2_2_5' id='input_2_2_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_2.6' id='input_2_2_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_2_4\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_4\"><label class='gfield_label gform-field-label' for='input_2_4' >Contact Name(s)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_2_4' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_5\"  class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_5\"><label class='gfield_label gform-field-label' for='input_2_5' >Email for Statements<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_5' id='input_2_5' type='text' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_2_6\"  class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_6\"><label class='gfield_label gform-field-label' for='input_2_6' >Email for Shipping Notifications<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_6' id='input_2_6' type='text' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_2_8\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_8\"><label class='gfield_label gform-field-label' for='input_2_8' >LMS that Customer Uses<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_2_8' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_9\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_9\"><label class='gfield_label gform-field-label' for='input_2_9' >Does Customer Use Opticom?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_2_9' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_10\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_10\"><label class='gfield_label gform-field-label' for='input_2_10' >Total Pairs Per Day the Lab is Producing:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_2_10' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_14\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_14\"><h2 class=\"gsection_title\">Products<\/h2><\/li><li id=\"field_2_56\"  class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_56\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Which products do you plan to purchase from TOG USA?<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_2_56'><li class='gchoice gchoice_select_all'>\n\t\t\t\t\t\t<input class='gfield-choice-input' type='checkbox' id='choice_56_select_all'   onclick='gformToggleCheckboxes( this )' onkeypress='gformToggleCheckboxes( this )' \/>\n\t\t\t\t\t\t<label for='choice_56_select_all' id='label_56_select_all' class='gform-field-label  gform-field-label--type-inline' data-label-select='Select All' data-label-deselect='Deselect All'>Select All<\/label>\n\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.1' type='checkbox'  value='1.50 Clear SFSV UC'  id='choice_2_56_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_1' id='label_2_56_1' class='gform-field-label gform-field-label--type-inline'>1.50 Clear SFSV UC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.2' type='checkbox'  value='1.50 Clear SFSV HC'  id='choice_2_56_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_2' id='label_2_56_2' class='gform-field-label gform-field-label--type-inline'>1.50 Clear SFSV HC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.3' type='checkbox'  value='1.50 Bluloc SFSV HC'  id='choice_2_56_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_3' id='label_2_56_3' class='gform-field-label gform-field-label--type-inline'>1.50 Bluloc SFSV HC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.4' type='checkbox'  value='1.50 Transitions Gen 8 Gray SFSV HC'  id='choice_2_56_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_4' id='label_2_56_4' class='gform-field-label gform-field-label--type-inline'>1.50 Transitions Gen 8 Gray SFSV HC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.5' type='checkbox'  value='1.50 Transitions Gen 8 Brown SFSV HC'  id='choice_2_56_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_5' id='label_2_56_5' class='gform-field-label gform-field-label--type-inline'>1.50 Transitions Gen 8 Brown SFSV HC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.6' type='checkbox'  value='1.53 Trivex Clear SFSV HC'  id='choice_2_56_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_6' id='label_2_56_6' class='gform-field-label gform-field-label--type-inline'>1.53 Trivex Clear SFSV HC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.7' type='checkbox'  value='1.53 Trivex Clear SFSV UC'  id='choice_2_56_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_7' id='label_2_56_7' class='gform-field-label gform-field-label--type-inline'>1.53 Trivex Clear SFSV UC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.8' type='checkbox'  value='1.53 Trivex Super AR FSV HC'  id='choice_2_56_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_8' id='label_2_56_8' class='gform-field-label gform-field-label--type-inline'>1.53 Trivex Super AR FSV HC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.9' type='checkbox'  value='1.53 Trivex Bluloc SFSV HC'  id='choice_2_56_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_9' id='label_2_56_9' class='gform-field-label gform-field-label--type-inline'>1.53 Trivex Bluloc SFSV HC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.11' type='checkbox'  value='1.53 Trivex Transitions Gray SFSV HC'  id='choice_2_56_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_11' id='label_2_56_11' class='gform-field-label gform-field-label--type-inline'>1.53 Trivex Transitions Gray SFSV HC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.12' type='checkbox'  value='1.53 Trivex Transitions Brown SFSV HC'  id='choice_2_56_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_12' id='label_2_56_12' class='gform-field-label gform-field-label--type-inline'>1.53 Trivex Transitions Brown SFSV HC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.13' type='checkbox'  value='1.60 Tribrid Clear SFSV UC'  id='choice_2_56_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_13' id='label_2_56_13' class='gform-field-label gform-field-label--type-inline'>1.60 Tribrid Clear SFSV UC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.14' type='checkbox'  value='1.60 Tribrid Clear SFSV HC'  id='choice_2_56_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_14' id='label_2_56_14' class='gform-field-label gform-field-label--type-inline'>1.60 Tribrid Clear SFSV HC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.15' type='checkbox'  value='1.60 Tribrid Bluloc SFSV HC'  id='choice_2_56_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_15' id='label_2_56_15' class='gform-field-label gform-field-label--type-inline'>1.60 Tribrid Bluloc SFSV HC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.16' type='checkbox'  value='1.60 Tribrid Transitions Gen 8 Gray SFSV HC'  id='choice_2_56_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_16' id='label_2_56_16' class='gform-field-label gform-field-label--type-inline'>1.60 Tribrid Transitions Gen 8 Gray SFSV HC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_17'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.17' type='checkbox'  value='1.60 Tribrid Transitions Gen 8 Brown SFSV HC'  id='choice_2_56_17'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_17' id='label_2_56_17' class='gform-field-label gform-field-label--type-inline'>1.60 Tribrid Transitions Gen 8 Brown SFSV HC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_18'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.18' type='checkbox'  value='1.60 Clear SFSV UC'  id='choice_2_56_18'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_18' id='label_2_56_18' class='gform-field-label gform-field-label--type-inline'>1.60 Clear SFSV UC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_19'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.19' type='checkbox'  value='1.60 Clear SFSV HC'  id='choice_2_56_19'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_19' id='label_2_56_19' class='gform-field-label gform-field-label--type-inline'>1.60 Clear SFSV HC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_21'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.21' type='checkbox'  value='1.60 Bluloc SFSV HC'  id='choice_2_56_21'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_21' id='label_2_56_21' class='gform-field-label gform-field-label--type-inline'>1.60 Bluloc SFSV HC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_22'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.22' type='checkbox'  value='1.60 Transitions Gen 8 Gray SFSV HC'  id='choice_2_56_22'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_22' id='label_2_56_22' class='gform-field-label gform-field-label--type-inline'>1.60 Transitions Gen 8 Gray SFSV HC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_23'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.23' type='checkbox'  value='1.60 Transitions Gen 8 Brown SFSV HC'  id='choice_2_56_23'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_23' id='label_2_56_23' class='gform-field-label gform-field-label--type-inline'>1.60 Transitions Gen 8 Brown SFSV HC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_24'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.24' type='checkbox'  value='1.67 Clear SFSV UC'  id='choice_2_56_24'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_24' id='label_2_56_24' class='gform-field-label gform-field-label--type-inline'>1.67 Clear SFSV UC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_25'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.25' type='checkbox'  value='1.67 Clear SFSV HC'  id='choice_2_56_25'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_25' id='label_2_56_25' class='gform-field-label gform-field-label--type-inline'>1.67 Clear SFSV HC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_26'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.26' type='checkbox'  value='1.67 BluLoc SFSV HC'  id='choice_2_56_26'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_26' id='label_2_56_26' class='gform-field-label gform-field-label--type-inline'>1.67 BluLoc SFSV HC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_27'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.27' type='checkbox'  value='1.67 Transitions Gen 8 Gray SFSV HC'  id='choice_2_56_27'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_27' id='label_2_56_27' class='gform-field-label gform-field-label--type-inline'>1.67 Transitions Gen 8 Gray SFSV HC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_28'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.28' type='checkbox'  value='1.67 Transitions Gen 8 Brown SFSV HC'  id='choice_2_56_28'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_28' id='label_2_56_28' class='gform-field-label gform-field-label--type-inline'>1.67 Transitions Gen 8 Brown SFSV HC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_29'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.29' type='checkbox'  value='1.74 Leafeco Clear SFSV UC'  id='choice_2_56_29'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_29' id='label_2_56_29' class='gform-field-label gform-field-label--type-inline'>1.74 Leafeco Clear SFSV UC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_31'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.31' type='checkbox'  value='1.74 Leafeco Clear SFSV HC'  id='choice_2_56_31'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_31' id='label_2_56_31' class='gform-field-label gform-field-label--type-inline'>1.74 Leafeco Clear SFSV HC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_32'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.32' type='checkbox'  value='1.74 Leafeco Bluloc SFSV HC'  id='choice_2_56_32'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_32' id='label_2_56_32' class='gform-field-label gform-field-label--type-inline'>1.74 Leafeco Bluloc SFSV HC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_33'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.33' type='checkbox'  value='1.74 Leafeco Transitions Gray SFSV HC'  id='choice_2_56_33'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_33' id='label_2_56_33' class='gform-field-label gform-field-label--type-inline'>1.74 Leafeco Transitions Gray SFSV HC<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_56_34'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.34' type='checkbox'  value='1.74 Leafeco Transitions Brown SFSV HC'  id='choice_2_56_34'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_56_34' id='label_2_56_34' class='gform-field-label gform-field-label--type-inline'>1.74 Leafeco Transitions Brown SFSV HC<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_2_57\"  class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_57\"><label class='gfield_label gform-field-label' for='input_2_57' >Any Additional Comments<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_57' id='input_2_57' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_2_53\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_53\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Shipping<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_2_53'>Please check one for default<\/div><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_2_53'><li class='gchoice gchoice_2_53_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.1' type='checkbox'  value='Ground'  id='choice_2_53_1'   aria-describedby=\"gfield_description_2_53\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_2_53_1' id='label_2_53_1' class='gform-field-label gform-field-label--type-inline'>Ground<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_53_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.2' type='checkbox'  value='2nd Day Air'  id='choice_2_53_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_53_2' id='label_2_53_2' class='gform-field-label gform-field-label--type-inline'>2nd Day Air<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_53_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.3' type='checkbox'  value='Next Day Air'  id='choice_2_53_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_53_3' id='label_2_53_3' class='gform-field-label gform-field-label--type-inline'>Next Day Air<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_53_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.4' type='checkbox'  value='Next Day Air Saver'  id='choice_2_53_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_53_4' id='label_2_53_4' class='gform-field-label gform-field-label--type-inline'>Next Day Air Saver<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_53_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.5' type='checkbox'  value='Other (List Below)'  id='choice_2_53_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_53_5' id='label_2_53_5' class='gform-field-label gform-field-label--type-inline'>Other (List Below)<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_2_54\"  class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_54\"><label class='gfield_label gform-field-label screen-reader-text' for='input_2_54' >Please list other shipping requested<\/label><div class='gfield_description' id='gfield_description_2_54'>Please list other shipping requested<\/div><div class='ginput_container ginput_container_text'><input name='input_54' id='input_2_54' type='text' value='' class='medium'  aria-describedby=\"gfield_description_2_54\"    aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_55\"  class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_55\"><label class='gfield_label gform-field-label' for='input_2_55' >Other Comments<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_55' id='input_2_55' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><\/ul><\/div>\n        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_2' class='gform_button button' value='Submit'  onclick='if(window[\"gf_submitting_2\"]){return false;}  window[\"gf_submitting_2\"]=true;  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_2\"]){return false;} window[\"gf_submitting_2\"]=true;  jQuery(\"#gform_2\").trigger(\"submit\",[true]); }' \/> \n            <input type='hidden' class='gform_hidden' name='is_submit_2' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='2' \/>\n            \n            <input type='hidden' class='gform_hidden' 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