{"id":71503,"date":"2024-08-04T15:19:56","date_gmt":"2024-08-04T22:19:56","guid":{"rendered":"http:\/\/ama-d36.org\/archive\/d36\/?page_id=71503"},"modified":"2025-06-19T16:59:06","modified_gmt":"2025-06-19T23:59:06","slug":"2026-district-36-charter-application","status":"publish","type":"page","link":"https:\/\/ama-d36.org\/archive\/d36\/2026-district-36-charter-application\/","title":{"rendered":"2026 District 36 Charter Application"},"content":{"rendered":"<table style=\"height: 159px; width: 97.1219%; border-collapse: collapse; background-color: #adf7f1;\" border=\"1\">\n<tbody>\n<tr style=\"height: 164px;\">\n<td style=\"width: 20.3031%; height: 164px; background-color: #a8f0e7;\"><a href=\"http:\/\/ama-d36.org\/archive\/\" target=\"_blank\" rel=\"noopener\"><img decoding=\"async\" loading=\"lazy\" class=\"alignleft wp-image-67452\" src=\"http:\/\/ama-d36.org\/archive\/d36\/wp-content\/uploads\/2020\/01\/D36_large_t.png\" alt=\"\" width=\"149\" height=\"149\" \/><\/a><\/td>\n<td style=\"width: 58.8787%; background-color: #c6d6f7; height: 164px;\">\n<h4 style=\"text-align: center;\"><span style=\"color: #0000ff;\"><b>DISTRICT 36 MOTORCYCLE SPORTS COMMITTEE, INC<\/b><\/span><\/h4>\n<h4 style=\"text-align: center;\"><span style=\"color: #0000ff;\"><b><span style=\"color: #ff0000; font-size: 18pt;\">2026 <\/span>District 36 Charter Application<\/b><\/span><\/h4>\n<\/td>\n<td style=\"width: 20.8183%; background-color: #a8f0e7;\">\n<h4 style=\"text-align: center;\"><span style=\"color: #0000ff;\"><b><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-69811 aligncenter\" src=\"http:\/\/ama-d36.org\/archive\/d36\/wp-content\/uploads\/2022\/06\/d36_lao_sm_T_6-1-22.png\" alt=\"\" width=\"138\" height=\"137\" srcset=\"https:\/\/ama-d36.org\/archive\/d36\/wp-content\/uploads\/2022\/06\/d36_lao_sm_T_6-1-22.png 228w, https:\/\/ama-d36.org\/archive\/d36\/wp-content\/uploads\/2022\/06\/d36_lao_sm_T_6-1-22-150x150.png 150w\" sizes=\"(max-width: 138px) 100vw, 138px\" \/><\/b><\/span><\/h4>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n                <div class='gf_browser_gecko gform_wrapper' id='gform_wrapper_130' style='display:none'><div id='gf_130' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_130' id='gform_130'  action='\/archive\/d36\/wp-json\/wp\/v2\/pages\/71503#gf_130'>\n                        <div class='gform_body'><ul id='gform_fields_130' class='gform_fields top_label form_sublabel_above description_above'><li id='field_130_28'  class='gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above field_description_above gfield_visibility_visible' ><strong>Instructions:\u00a0 Fill this form out completely and once submitted you will be directed to PayPal to pay the appropriate fees.\u00a0 Once paid you will receive an email confirmation from PayPal and that is your receipt for payment.<\/strong>\n\n<strong>The Fees are:<\/strong>\n<ul>\n \t<li><strong>$150 Charter Fee for any club or promoter that puts on Cross Country Races<\/strong><\/li>\n \t<li><strong>$50 Charter Fee for any club, promoter, or group that host or does not host meets other than Cross Country<\/strong><\/li>\n \t<li><b>$150 Security Deposit paid by each club, promoter or group chartering with District 36.\u00a0 This is a one time fee paid when first chartering with District 36 and once paid it is \"rolled over\" each year until it is refunded at such time that the club, promoter or group leaves the District in good standing.\u00a0<\/b><\/li>\n<\/ul>\n<strong>Note: After the Sanction meeting in September a late fee of $50 is added to the above pricing.  Ref: D36 Operations Manual; 1.2; paragraph 1)<\/strong>\n<p><strong>Thank you for Chartering with District 36 and your support of <span style=\"text-decoration: underline;\">your<\/span> racing organization!<\/strong><\/li><li id='field_130_33'  class='gfield gsection field_sublabel_above field_description_above gfield_visibility_visible' ><h2 class='gsection_title'><\/h2><\/li><li id='field_130_29'  class='gfield gsection field_sublabel_above field_description_above gfield_visibility_visible' ><h2 class='gsection_title'><\/h2><\/li><li id='field_130_48'  class='gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above field_description_above gfield_visibility_visible' ><span style=\"font-size: 14pt; color: #ff0000;\">*\u00a0<span style=\"color: #000000;\">= <span style=\"font-size: 11pt;\">Required<\/span><\/span><\/span><\/li><li id='field_130_86'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label gfield_label_before_complex'  >Date<span class='gfield_required'>*<\/span><\/label><div id='input_130_86' class='ginput_container ginput_container_date'><div class='clear-multi'><div class='gfield_date_month ginput_container ginput_container_date' id='input_130_86_1_container'>\n                                            <label for='input_130_86_1' >MM<\/label>\n                                            <input type='number' maxlength='2' name='input_86[]' id='input_130_86_1' value=''    min='1' max='12' step='1'\/>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date' id='input_130_86_2_container'>\n                                            <label for='input_130_86_2' >DD<\/label>\n                                            <input type='number' maxlength='2' name='input_86[]' id='input_130_86_2' value=''    min='1' max='31' step='1'\/>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date' id='input_130_86_3_container'>\n                                            <label for='input_130_86_3' >YYYY<\/label>\n                                            <input type='number' maxlength='4' name='input_86[]' id='input_130_86_3' value=''    min='1920' max='2027' step='1'\/>\n                                       <\/div>\n                                   <\/div><\/div><\/li><li id='field_130_1'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_1' >Club \/ Promoter Name<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_130_1' type='text' value='' class='medium' maxlength='50'    aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_130_10'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label'  >Incorporated?<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_130_10'><li class='gchoice_130_10_0'><input name='input_10' type='radio' value='Yes'  id='choice_130_10_0'    \/><label for='choice_130_10_0' id='label_130_10_0'>Yes<\/label><\/li><li class='gchoice_130_10_1'><input name='input_10' type='radio' value='No'  id='choice_130_10_1'    \/><label for='choice_130_10_1' id='label_130_10_1'>No<\/label><\/li><\/ul><\/div><\/li><li id='field_130_12'  class='gfield gf_left_third gfield_contains_required field_sublabel_above field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_130_12' >Number of D36 Members<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_130_12' type='text' value='' class='small' maxlength='3' aria-describedby=\"gfield_description_130_12\"   aria-required=\"true\" aria-invalid=\"false\" \/><\/div><div class='gfield_description' id='gfield_description_130_12'>If none enter 0<\/div><\/li><li id='field_130_11'  class='gfield gf_middle_third gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_11' >Total Number Of Members<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_130_11' type='text' value='' class='small' maxlength='3'    aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_130_16'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label gfield_label_before_complex'  >Mailing Address<span class='gfield_required'>*<\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address' id='input_130_16' >\n                         <span class='ginput_full address_line_1' id='input_130_16_1_container' >\n                                        <label for='input_130_16_1' id='input_130_16_1_label' >Street or PO Box<\/label>\n                                        <input type='text' name='input_16.1' id='input_130_16_1' value=''    aria-required=\"true\"\/>\n                                    <\/span><span class='ginput_full address_line_2' id='input_130_16_2_container' >\n                                        <label for='input_130_16_2' id='input_130_16_2_label' >Address Line 2<\/label>\n                                        <input type='text' name='input_16.2' id='input_130_16_2' value=''   \/>\n                                    <\/span><span class='ginput_left address_city' id='input_130_16_3_container' >\n                                    <label for='input_130_16_3' id='input_130_16_3_label' >City<\/label>\n                                    <input type='text' name='input_16.3' id='input_130_16_3' value=''    aria-required=\"true\"\/>\n                                 <\/span><span class='ginput_right address_state' id='input_130_16_4_container' >\n                                        <label for='input_130_16_4' id='input_130_16_4_label' >State \/ Province \/ Region<\/label>\n                                        <input type='text' name='input_16.4' id='input_130_16_4' value=''      aria-required=\"true\"\/>\n                                      <\/span><span class='ginput_left address_zip' id='input_130_16_5_container' >\n                                    <label for='input_130_16_5' id='input_130_16_5_label' >ZIP \/ Postal Code<\/label>\n                                    <input type='text' name='input_16.5' id='input_130_16_5' value=''    aria-required=\"true\"\/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_16.6' id='input_130_16_6' value=''\/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id='field_130_19'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_19' >Email<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_19' id='input_130_19' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\" \/>\n                        <\/div><\/li><li id='field_130_17'  class='gfield gf_left_third field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_17' >Website<\/label><div class='ginput_container ginput_container_website'>\n                    <input name='input_17' id='input_130_17' type='url' value='' class='small'    placeholder='https:\/\/'  aria-invalid=\"false\"\/>\n                <\/div><\/li><li id='field_130_18'  class='gfield gf_middle_third field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_18' >Social Media Webpage<\/label><div class='ginput_container ginput_container_website'>\n                    <input name='input_18' id='input_130_18' type='url' value='' class='small'    placeholder='https:\/\/'  aria-invalid=\"false\"\/>\n                <\/div><\/li><li id='field_130_32'  class='gfield gsection field_sublabel_above field_description_above gfield_visibility_visible' ><h2 class='gsection_title'><\/h2><\/li><li id='field_130_5'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label'  >What Type Of Organization Are You?<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_130_5'><li class='gchoice_130_5_0'><input name='input_5' type='radio' value='AMA Chartered Club'  id='choice_130_5_0'    \/><label for='choice_130_5_0' id='label_130_5_0'>AMA Chartered Club<\/label><\/li><li class='gchoice_130_5_1'><input name='input_5' type='radio' value='AMA Chartered Promoter'  id='choice_130_5_1'    \/><label for='choice_130_5_1' id='label_130_5_1'>AMA Chartered Promoter<\/label><\/li><li class='gchoice_130_5_2'><input name='input_5' type='radio' value='Chartered With Non-AMA Organization'  id='choice_130_5_2'    \/><label for='choice_130_5_2' id='label_130_5_2'>Chartered With Non-AMA Organization<\/label><\/li><li class='gchoice_130_5_3'><input name='input_5' type='radio' value='Other Club Association Group, Promoter, (non-Chartered)'  id='choice_130_5_3'    \/><label for='choice_130_5_3' id='label_130_5_3'>Other Club Association Group, Promoter, (non-Chartered)<\/label><\/li><\/ul><\/div><\/li><li id='field_130_7'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_7' >What is your Organization&#039;s  Parent Body?<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_7' id='input_130_7' type='text' value='' class='medium' maxlength='35'    aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_130_6'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_6' >Enter your AMA Charter Number<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_130_6' type='text' value='' class='medium' maxlength='10'    aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_130_8'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_8' >Enter the Name Of The Group \/ Association Your Organization Is Part Of<span class='gfield_required'>*<\/span><\/label><div class='gfield_description' id='gfield_description_130_8'>Enter None if not associated with any group or association<\/div><div class='ginput_container ginput_container_text'><input name='input_8' id='input_130_8' type='text' value='' class='medium' maxlength='35' aria-describedby=\"gfield_description_130_8\"   aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_130_13'  class='gfield gsection field_sublabel_above field_description_above gfield_visibility_visible' ><h2 class='gsection_title'><\/h2><\/li><li id='field_130_3'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label'  >What Is Your Organization&#039;s Main Activities?<span class='gfield_required'>*<\/span><\/label><div class='gfield_description' id='gfield_description_130_3'>list all that apply<\/div><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_130_3'><li class='gchoice_130_3_1'>\n\t\t\t\t\t\t\t\t<input name='input_3.1' type='checkbox'  value='Off Road'  id='choice_130_3_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_130_3_1' id='label_130_3_1'>Off Road<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_130_3_2'>\n\t\t\t\t\t\t\t\t<input name='input_3.2' type='checkbox'  value='On Road'  id='choice_130_3_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_130_3_2' id='label_130_3_2'>On Road<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_130_3_3'>\n\t\t\t\t\t\t\t\t<input name='input_3.3' type='checkbox'  value='Dual Sport'  id='choice_130_3_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_130_3_3' id='label_130_3_3'>Dual Sport<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_130_3_4'>\n\t\t\t\t\t\t\t\t<input name='input_3.4' type='checkbox'  value='Promoter'  id='choice_130_3_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_130_3_4' id='label_130_3_4'>Promoter<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_130_3_5'>\n\t\t\t\t\t\t\t\t<input name='input_3.5' type='checkbox'  value='Competition'  id='choice_130_3_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_130_3_5' id='label_130_3_5'>Competition<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_130_3_6'>\n\t\t\t\t\t\t\t\t<input name='input_3.6' type='checkbox'  value='Pleasure'  id='choice_130_3_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_130_3_6' id='label_130_3_6'>Pleasure<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_130_3_7'>\n\t\t\t\t\t\t\t\t<input name='input_3.7' type='checkbox'  value='Other'  id='choice_130_3_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_130_3_7' id='label_130_3_7'>Other<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id='field_130_49'  class='gfield gf_left_third gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_49' >Key Contact Person<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_49' id='input_130_49' type='text' value='' class='medium' maxlength='25'    aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_130_53'  class='gfield gf_right_third field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_53' >District 36 Number<\/label><div class='ginput_container ginput_container_text'><input name='input_53' id='input_130_53' type='text' value='' class='small'      aria-invalid=\"false\" \/><\/div><\/li><li id='field_130_52'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label gfield_label_before_complex'  >Address<span class='gfield_required'>*<\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address' id='input_130_52' >\n                         <span class='ginput_full address_line_1' id='input_130_52_1_container' >\n                                        <label for='input_130_52_1' id='input_130_52_1_label' >Street Address<\/label>\n                                        <input type='text' name='input_52.1' id='input_130_52_1' value=''    aria-required=\"true\"\/>\n                                    <\/span><span class='ginput_left address_city' id='input_130_52_3_container' >\n                                    <label for='input_130_52_3' id='input_130_52_3_label' >City<\/label>\n                                    <input type='text' name='input_52.3' id='input_130_52_3' value=''    aria-required=\"true\"\/>\n                                 <\/span><span class='ginput_right address_state' id='input_130_52_4_container' >\n                                        <label for='input_130_52_4' id='input_130_52_4_label' >State<\/label>\n                                        <select name='input_52.4' id='input_130_52_4'     aria-required=\"true\"><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/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='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='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/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='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                                      <\/span><span class='ginput_left address_zip' id='input_130_52_5_container' >\n                                    <label for='input_130_52_5' id='input_130_52_5_label' >ZIP Code<\/label>\n                                    <input type='text' name='input_52.5' id='input_130_52_5' value=''    aria-required=\"true\"\/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_52.6' id='input_130_52_6' value='United States'\/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id='field_130_50'  class='gfield gf_left_half gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_50' >Email<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_50' id='input_130_50' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\" \/>\n                        <\/div><\/li><li id='field_130_51'  class='gfield gf_right_third gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_51' >Phone<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_51' id='input_130_51' type='tel' value='' class='small'   aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/li><li id='field_130_54'  class='gfield gsection field_sublabel_above field_description_above gfield_visibility_visible' ><h2 class='gsection_title'><\/h2><\/li><li id='field_130_55'  class='gfield gf_left_third gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_55' >President<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_55' id='input_130_55' type='text' value='' class='medium' maxlength='25'    aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_130_56'  class='gfield gf_right_third field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_56' >District 36 Number<\/label><div class='ginput_container ginput_container_text'><input name='input_56' id='input_130_56' type='text' value='' class='small'      aria-invalid=\"false\" \/><\/div><\/li><li id='field_130_57'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label gfield_label_before_complex'  >Address<span class='gfield_required'>*<\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address' id='input_130_57' >\n                         <span class='ginput_full address_line_1' id='input_130_57_1_container' >\n                                        <label for='input_130_57_1' id='input_130_57_1_label' >Street Address<\/label>\n                                        <input type='text' name='input_57.1' id='input_130_57_1' value=''    aria-required=\"true\"\/>\n                                    <\/span><span class='ginput_left address_city' id='input_130_57_3_container' >\n                                    <label for='input_130_57_3' id='input_130_57_3_label' >City<\/label>\n                                    <input type='text' name='input_57.3' id='input_130_57_3' value=''    aria-required=\"true\"\/>\n                                 <\/span><span class='ginput_right address_state' id='input_130_57_4_container' >\n                                        <label for='input_130_57_4' id='input_130_57_4_label' >State<\/label>\n                                        <select name='input_57.4' id='input_130_57_4'     aria-required=\"true\"><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/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='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='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/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='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                                      <\/span><span class='ginput_left address_zip' id='input_130_57_5_container' >\n                                    <label for='input_130_57_5' id='input_130_57_5_label' >ZIP Code<\/label>\n                                    <input type='text' name='input_57.5' id='input_130_57_5' value=''    aria-required=\"true\"\/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_57.6' id='input_130_57_6' value='United States'\/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id='field_130_58'  class='gfield gf_left_half gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_58' >Email<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_58' id='input_130_58' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\" \/>\n                        <\/div><\/li><li id='field_130_59'  class='gfield gf_right_third gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_59' >Phone<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_59' id='input_130_59' type='tel' value='' class='small'   aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/li><li id='field_130_60'  class='gfield gsection field_sublabel_above field_description_above gfield_visibility_visible' ><h2 class='gsection_title'><\/h2><\/li><li id='field_130_64'  class='gfield gf_left_third gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_64' >Secretary<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_64' id='input_130_64' type='text' value='' class='medium' maxlength='25'    aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_130_69'  class='gfield gf_right_third field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_69' >District 36 Number<\/label><div class='ginput_container ginput_container_text'><input name='input_69' id='input_130_69' type='text' value='' class='small'      aria-invalid=\"false\" \/><\/div><\/li><li id='field_130_63'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label gfield_label_before_complex'  >Address<span class='gfield_required'>*<\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address' id='input_130_63' >\n                         <span class='ginput_full address_line_1' id='input_130_63_1_container' >\n                                        <label for='input_130_63_1' id='input_130_63_1_label' >Street Address<\/label>\n                                        <input type='text' name='input_63.1' id='input_130_63_1' value=''    aria-required=\"true\"\/>\n                                    <\/span><span class='ginput_left address_city' id='input_130_63_3_container' >\n                                    <label for='input_130_63_3' id='input_130_63_3_label' >City<\/label>\n                                    <input type='text' name='input_63.3' id='input_130_63_3' value=''    aria-required=\"true\"\/>\n                                 <\/span><span class='ginput_right address_state' id='input_130_63_4_container' >\n                                        <label for='input_130_63_4' id='input_130_63_4_label' >State<\/label>\n                                        <select name='input_63.4' id='input_130_63_4'     aria-required=\"true\"><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/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='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='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/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='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                                      <\/span><span class='ginput_left address_zip' id='input_130_63_5_container' >\n                                    <label for='input_130_63_5' id='input_130_63_5_label' >ZIP Code<\/label>\n                                    <input type='text' name='input_63.5' id='input_130_63_5' value=''    aria-required=\"true\"\/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_63.6' id='input_130_63_6' value='United States'\/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id='field_130_62'  class='gfield gf_left_half gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_62' >Email<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_62' id='input_130_62' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\" \/>\n                        <\/div><\/li><li id='field_130_61'  class='gfield gf_right_third gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_61' >Phone<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_61' id='input_130_61' type='tel' value='' class='small'   aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/li><li id='field_130_65'  class='gfield gsection field_sublabel_above field_description_above gfield_visibility_visible' ><h2 class='gsection_title'><\/h2><\/li><li id='field_130_71'  class='gfield gf_left_third gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_71' >Treasurer<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_71' id='input_130_71' type='text' value='' class='medium' maxlength='25'    aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_130_70'  class='gfield gf_right_third field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_70' >District 36 Number<\/label><div class='ginput_container ginput_container_text'><input name='input_70' id='input_130_70' type='text' value='' class='small'      aria-invalid=\"false\" \/><\/div><\/li><li id='field_130_68'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label gfield_label_before_complex'  >Address<span class='gfield_required'>*<\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address' id='input_130_68' >\n                         <span class='ginput_full address_line_1' id='input_130_68_1_container' >\n                                        <label for='input_130_68_1' id='input_130_68_1_label' >Street Address<\/label>\n                                        <input type='text' name='input_68.1' id='input_130_68_1' value=''    aria-required=\"true\"\/>\n                                    <\/span><span class='ginput_left address_city' id='input_130_68_3_container' >\n                                    <label for='input_130_68_3' id='input_130_68_3_label' >City<\/label>\n                                    <input type='text' name='input_68.3' id='input_130_68_3' value=''    aria-required=\"true\"\/>\n                                 <\/span><span class='ginput_right address_state' id='input_130_68_4_container' >\n                                        <label for='input_130_68_4' id='input_130_68_4_label' >State<\/label>\n                                        <select name='input_68.4' id='input_130_68_4'     aria-required=\"true\"><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/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='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='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/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='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                                      <\/span><span class='ginput_left address_zip' id='input_130_68_5_container' >\n                                    <label for='input_130_68_5' id='input_130_68_5_label' >ZIP Code<\/label>\n                                    <input type='text' name='input_68.5' id='input_130_68_5' value=''    aria-required=\"true\"\/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_68.6' id='input_130_68_6' value='United States'\/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id='field_130_67'  class='gfield gf_left_half gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_67' >Email<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_67' id='input_130_67' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\" \/>\n                        <\/div><\/li><li id='field_130_66'  class='gfield gf_right_third gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_66' >Phone<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_66' id='input_130_66' type='tel' value='' class='small'   aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/li><li id='field_130_72'  class='gfield gsection field_sublabel_above field_description_above gfield_visibility_visible' ><h2 class='gsection_title'><\/h2><\/li><li id='field_130_75'  class='gfield gf_left_third gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_75' >Referee<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_75' id='input_130_75' type='text' value='' class='medium' maxlength='25'    aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_130_78'  class='gfield gf_right_third field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_78' >District 36 Number<\/label><div class='ginput_container ginput_container_text'><input name='input_78' id='input_130_78' type='text' value='' class='small'      aria-invalid=\"false\" \/><\/div><\/li><li id='field_130_77'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label gfield_label_before_complex'  >Address<span class='gfield_required'>*<\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address' id='input_130_77' >\n                         <span class='ginput_full address_line_1' id='input_130_77_1_container' >\n                                        <label for='input_130_77_1' id='input_130_77_1_label' >Street Address<\/label>\n                                        <input type='text' name='input_77.1' id='input_130_77_1' value=''    aria-required=\"true\"\/>\n                                    <\/span><span class='ginput_left address_city' id='input_130_77_3_container' >\n                                    <label for='input_130_77_3' id='input_130_77_3_label' >City<\/label>\n                                    <input type='text' name='input_77.3' id='input_130_77_3' value=''    aria-required=\"true\"\/>\n                                 <\/span><span class='ginput_right address_state' id='input_130_77_4_container' >\n                                        <label for='input_130_77_4' id='input_130_77_4_label' >State<\/label>\n                                        <select name='input_77.4' id='input_130_77_4'     aria-required=\"true\"><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/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='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='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/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='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                                      <\/span><span class='ginput_left address_zip' id='input_130_77_5_container' >\n                                    <label for='input_130_77_5' id='input_130_77_5_label' >ZIP Code<\/label>\n                                    <input type='text' name='input_77.5' id='input_130_77_5' value=''    aria-required=\"true\"\/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_77.6' id='input_130_77_6' value='United States'\/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id='field_130_76'  class='gfield gf_left_half gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_76' >Email<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_76' id='input_130_76' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\" \/>\n                        <\/div><\/li><li id='field_130_73'  class='gfield gf_right_third gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_73' >Phone<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_73' id='input_130_73' type='tel' value='' class='small'   aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/li><li id='field_130_74'  class='gfield gsection field_sublabel_above field_description_above gfield_visibility_visible' ><h2 class='gsection_title'><\/h2><\/li><li id='field_130_84'  class='gfield gf_left_third gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_84' >Legislative Officer<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_84' id='input_130_84' type='text' value='' class='medium' maxlength='25'    aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_130_85'  class='gfield gf_right_third field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_85' >District 36 Number<\/label><div class='ginput_container ginput_container_text'><input name='input_85' id='input_130_85' type='text' value='' class='small'      aria-invalid=\"false\" \/><\/div><\/li><li id='field_130_83'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label gfield_label_before_complex'  >Address<span class='gfield_required'>*<\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address' id='input_130_83' >\n                         <span class='ginput_full address_line_1' id='input_130_83_1_container' >\n                                        <label for='input_130_83_1' id='input_130_83_1_label' >Street Address<\/label>\n                                        <input type='text' name='input_83.1' id='input_130_83_1' value=''    aria-required=\"true\"\/>\n                                    <\/span><span class='ginput_left address_city' id='input_130_83_3_container' >\n                                    <label for='input_130_83_3' id='input_130_83_3_label' >City<\/label>\n                                    <input type='text' name='input_83.3' id='input_130_83_3' value=''    aria-required=\"true\"\/>\n                                 <\/span><span class='ginput_right address_state' id='input_130_83_4_container' >\n                                        <label for='input_130_83_4' id='input_130_83_4_label' >State<\/label>\n                                        <select name='input_83.4' id='input_130_83_4'     aria-required=\"true\"><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/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='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='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/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='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                                      <\/span><span class='ginput_left address_zip' id='input_130_83_5_container' >\n                                    <label for='input_130_83_5' id='input_130_83_5_label' >ZIP Code<\/label>\n                                    <input type='text' name='input_83.5' id='input_130_83_5' value=''    aria-required=\"true\"\/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_83.6' id='input_130_83_6' value='United States'\/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id='field_130_82'  class='gfield gf_left_half gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_82' >Email<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_82' id='input_130_82' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\" \/>\n                        <\/div><\/li><li id='field_130_79'  class='gfield gf_right_third gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_79' >Phone<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_79' id='input_130_79' type='tel' value='' class='small'   aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/li><li id='field_130_27'  class='gfield gsection field_sublabel_above field_description_above gfield_visibility_visible' ><h2 class='gsection_title'><\/h2><\/li><li id='field_130_34'  class='gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above field_description_above gfield_visibility_visible' ><span style=\"font-size: 14pt;\"><span style=\"font-size: 14pt;\"><b>Charter <\/b><\/span><span style=\"font-size: 18.6667px;\"><b>Category<\/b><\/span><span style=\"font-size: 14pt;\"><b>\u00a0and Charter Fees<\/b><\/span><\/span><\/li><li id='field_130_45'  class='gfield gfield_price gfield_price_130_45 gfield_product_130_45 gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label'  >1. Select Your Category<span class='gfield_required'>*<\/span><\/label><div class='gfield_description' id='gfield_description_130_45'>Note: A $50 Late fee applies after the 2025 Sanction Meeting when chartering  for 2026 <\/div><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_130_45'><li class='gchoice_130_45_0'><input name='input_45' type='radio' value='&lt;strong&gt;$200.00 Cross Country and Other Disciplines (includes $50 late fee)&lt;\/Strong&gt;|200'  id='choice_130_45_0'    \/><label for='choice_130_45_0' id='label_130_45_0'><strong>$200.00 Cross Country and Other Disciplines (includes $50 late fee)<\/Strong><\/label><\/li><li class='gchoice_130_45_1'><input name='input_45' type='radio' value='&lt;strong&gt;$100.00 All Disciplines Except Cross Country (includes $50 late fee)&lt;\/strong&gt;|100'  id='choice_130_45_1'    \/><label for='choice_130_45_1' id='label_130_45_1'><strong>$100.00 All Disciplines Except Cross Country (includes $50 late fee)<\/strong><\/label><\/li><li class='gchoice_130_45_2'><input name='input_45' type='radio' value='&lt;strong&gt;$100.00 Clubs or Groups Not Hosting Events (includes $50 late fee)&lt;\/strong&gt;|100'  id='choice_130_45_2'    \/><label for='choice_130_45_2' id='label_130_45_2'><strong>$100.00 Clubs or Groups Not Hosting Events (includes $50 late fee)<\/strong><\/label><\/li><\/ul><\/div><\/li><li id='field_130_20'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label'  >3. Are You Renewing from Last Year Or New To The District<span class='gfield_required'>*<\/span><\/label><div class='gfield_description' id='gfield_description_130_20'>(you are also new to the District if you let your past charter lapse and had your security deposit refunded)<\/div><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_130_20'><li class='gchoice_130_20_0'><input name='input_20' type='radio' value='Renewing'  id='choice_130_20_0'    \/><label for='choice_130_20_0' id='label_130_20_0'>Renewing<\/label><\/li><li class='gchoice_130_20_1'><input name='input_20' type='radio' value='New'  id='choice_130_20_1'    \/><label for='choice_130_20_1' id='label_130_20_1'>New<\/label><\/li><\/ul><\/div><\/li><li id='field_130_43'  class='gfield gfield_price gfield_price_130_43 gfield_product_130_43 gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_130_43_1' >Security 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