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Last active August 29, 2015 14:02
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form.html
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gistfile1.html
<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01//EN" "http://www.w3.org/TR/html4/strict.dtd"><html><head><link rel="shortcut icon" href="https://ssl.gstatic.com/docs/spreadsheets/forms/favicon_jfk2.png" type="image/x-icon">
<meta http-equiv="Content-type" content="text/html; charset=utf-8">
<meta http-equiv="X-UA-Compatible" content="IE=10; chrome=1;">
<meta name="fragment" content="!">
<base target="_blank">
<link rel="stylesheet" type="text/css" href="">
<link href='/static/forms/client/css/3377844631-formview_embedded_ltr.css' type='text/css' rel='stylesheet'>
<style type="text/css">
</style>
<style type="text/css">
</style>
<script type="text/javascript">
/**
* @license
*! H5F
* https://github.com/ryanseddon/H5F/
* Copyright (c) Ryan Seddon | Licensed MIT
*/
(function(e,t){"function"==typeof define&&define.amd?define(t):e.H5F=t()})(this,function(){var e,t,a,i,n,r,s,l,u,o,c,d,v,f,p,m,h,g,b,y,w,C,N,A,E,$,k=document,x=k.createElement("input"),q=/^[a-zA-Z0-9.!#$%&'*+-\/=?\^_`{|}~-]+@[a-zA-Z0-9-]+(?:\.[a-zA-Z0-9-]+)*$/,M=/[a-z][\-\.+a-z]*:\/\//i,L=/^(input|select|textarea)$/i;return r=function(e,t){var a=!e.nodeType||!1,i={validClass:"valid",invalidClass:"error",requiredClass:"required",placeholderClass:"placeholder"};if("object"==typeof t)for(var r in i)t[r]===void 0&&(t[r]=i[r]);if(n=t||i,a)for(var l=0,u=e.length;u>l;l++)s(e[l]);else s(e)},s=function(a){var i,n=a.elements,r=n.length,s=!!a.attributes.novalidate;if(b(a,"invalid",u,!0),b(a,"blur",u,!0),b(a,"input",u,!0),b(a,"keyup",u,!0),b(a,"focus",u,!0),b(a,"change",u,!0),b(a,"click",o,!0),b(a,"submit",function(i){e=!0,t||s||a.checkValidity()||w(i)},!1),!v())for(a.checkValidity=function(){return c(a)};r--;)i=!!n[r].attributes.required,"fieldset"!==n[r].nodeName.toLowerCase()&&l(n[r])},l=function(e){var t=e,a=g(t),n={type:t.getAttribute("type"),pattern:t.getAttribute("pattern"),placeholder:t.getAttribute("placeholder")},r=/^(email|url)$/i,s=/^(input|keyup)$/i,l=r.test(n.type)?n.type:n.pattern?n.pattern:!1,u=f(t,l),o=m(t,"step"),v=m(t,"min"),h=m(t,"max"),b=!(""===t.validationMessage||void 0===t.validationMessage);t.checkValidity=function(){return c.call(this,t)},t.setCustomValidity=function(e){d.call(t,e)},t.validity={valueMissing:a,patternMismatch:u,rangeUnderflow:v,rangeOverflow:h,stepMismatch:o,customError:b,valid:!(a||u||o||v||h||b)},n.placeholder&&!s.test(i)&&p(t)},u=function(e){var t=C(e)||e,a=/^(input|keyup|focusin|focus|change)$/i,r=/^(submit|image|button|reset)$/i,s=/^(checkbox|radio)$/i,o=!0;!L.test(t.nodeName)||r.test(t.type)||r.test(t.nodeName)||(i=e.type,v()||l(t),t.validity.valid&&(""!==t.value||s.test(t.type))||t.value!==t.getAttribute("placeholder")&&t.validity.valid?(A(t,[n.invalidClass,n.requiredClass]),N(t,n.validClass)):a.test(i)?t.validity.valueMissing&&A(t,[n.requiredClass,n.invalidClass,n.validClass]):t.validity.valueMissing?(A(t,[n.invalidClass,n.validClass]),N(t,n.requiredClass)):t.validity.valid||(A(t,[n.validClass,n.requiredClass]),N(t,n.invalidClass)),"input"===i&&o&&(y(t.form,"keyup",u,!0),o=!1))},c=function(t){var a,i,n,r,s=!1;if("form"===t.nodeName.toLowerCase()){a=t.elements;for(var l=0,o=a.length;o>l;l++)i=a[l],n=!!i.attributes.required,r=!!i.attributes.pattern,"fieldset"!==i.nodeName.toLowerCase()&&(n||r&&n)&&(u(i),i.validity.valid||s||(e&&i.focus(),s=!0));return!s}return u(t),t.validity.valid},d=function(e){var t=this;t.validationMessage=e},o=function(e){var a=C(e);a.attributes.formnovalidate&&"submit"===a.type&&(t=!0)},v=function(){return E(x,"validity")&&E(x,"checkValidity")},f=function(e,t){if("email"===t)return!q.test(e.value);if("url"===t)return!M.test(e.value);if(t){var i=e.getAttribute("placeholder"),n=e.value;return a=RegExp("^(?:"+t+")$"),n===i?!1:""===n?!1:!a.test(e.value)}return!1},p=function(e){var t={placeholder:e.getAttribute("placeholder")},a=/^(focus|focusin|submit)$/i,r=/^(input|textarea)$/i,s=/^password$/i,l=!!("placeholder"in x);l||!r.test(e.nodeName)||s.test(e.type)||(""!==e.value||a.test(i)?e.value===t.placeholder&&a.test(i)&&(e.value="",A(e,n.placeholderClass)):(e.value=t.placeholder,b(e.form,"submit",function(){i="submit",p(e)},!0),N(e,n.placeholderClass)))},m=function(e,t){var a=parseInt(e.getAttribute("min"),10)||0,i=parseInt(e.getAttribute("max"),10)||!1,n=parseInt(e.getAttribute("step"),10)||1,r=parseInt(e.value,10),s=(r-a)%n;return g(e)||isNaN(r)?"number"===e.getAttribute("type")?!0:!1:"step"===t?e.getAttribute("step")?0!==s:!1:"min"===t?e.getAttribute("min")?a>r:!1:"max"===t?e.getAttribute("max")?r>i:!1:void 0},h=function(e){var t=!!e.attributes.required;return t?g(e):!1},g=function(e){var t=e.getAttribute("placeholder"),a=/^(checkbox|radio)$/i,i=!!e.attributes.required;return!(!i||""!==e.value&&e.value!==t&&(!a.test(e.type)||$(e)))},b=function(e,t,a,i){E(window,"addEventListener")?e.addEventListener(t,a,i):E(window,"attachEvent")&&window.event!==void 0&&("blur"===t?t="focusout":"focus"===t&&(t="focusin"),e.attachEvent("on"+t,a))},y=function(e,t,a,i){E(window,"removeEventListener")?e.removeEventListener(t,a,i):E(window,"detachEvent")&&window.event!==void 0&&e.detachEvent("on"+t,a)},w=function(e){e=e||window.event,e.stopPropagation&&e.preventDefault?(e.stopPropagation(),e.preventDefault()):(e.cancelBubble=!0,e.returnValue=!1)},C=function(e){return e=e||window.event,e.target||e.srcElement},N=function(e,t){var a;e.className?(a=RegExp("(^|\\s)"+t+"(\\s|$)"),a.test(e.className)||(e.className+=" "+t)):e.className=t},A=function(e,t){var a,i,n="object"==typeof t?t.length:1,r=n;if(e.className)if(e.className===t)e.className="";else for(;n--;)a=RegExp("(^|\\s)"+(r>1?t[n]:t)+"(\\s|$)"),i=e.className.match(a),i&&3===i.length&&(e.className=e.className.replace(a,i[1]&&i[2]?" ":""))},E=function(e,t){var a=typeof e[t],i=RegExp("^function|object$","i");return!!(i.test(a)&&e[t]||"unknown"===a)},$=function(e){for(var t=document.getElementsByName(e.name),a=0;t.length>a;a++)if(t[a].checked)return!0;return!1},{setup:r}});
</script>
</head>
<body class="ss-base-body" dir="ltr">
<div class="ss-form-container"><div class="ss-header-image"></div>
<div class="ss-top-of-page"><div class="ss-form-heading"><h1 class="ss-form-title" dir="ltr">Fill out the form below</h1>
<div class="ss-form-desc ss-no-ignore-whitespace">Tell us about yourself</div>
<hr class="ss-email-break" style="display:none;">
<div class="ss-required-asterisk" aria-hidden="true">* Required</div></div></div>
<div class="ss-form"><form action="https://docs.google.com/forms/d/1ONXeo4ycB4xV5oy6HvzVdxPLbt5_rSyTaXMGP9fxLlM/formResponse?embedded=true" method="POST" id="ss-form" target="hidden_iframe" onsubmit="submitted=true;"><ol role="list" class="ss-question-list" style="padding-left: 0">
<div class="ss-form-question errorbox-good" role="listitem">
<div dir="ltr" class="ss-item ss-text"><div class="ss-form-entry">
<label class="ss-q-item-label" for="entry_1413134530"><div class="ss-q-title">What is your preferred title?
</div>
<div class="ss-q-help ss-secondary-text" dir="ltr">eg. Mr, Mrs, Ms, Dr </div></label>
<input type="text" name="entry.1413134530" value="" class="ss-q-short" id="entry_1413134530" dir="auto" aria-label="What is your preferred title? eg. Mr, Mrs, Ms, Dr " title="">
<div class="error-message" id="566926331_errorMessage"></div>
<div class="required-message">This is a required question</div>
</div></div></div> <div class="ss-form-question errorbox-good" role="listitem">
<div dir="ltr" class="ss-item ss-item-required ss-text"><div class="ss-form-entry">
<label class="ss-q-item-label" for="entry_412766108"><div class="ss-q-title">What is your first name?
<label for="itemView.getDomIdToLabel()" aria-label="(Required field)"></label>
<span class="ss-required-asterisk">*</span></div>
<div class="ss-q-help ss-secondary-text" dir="ltr"></div></label>
<input type="text" name="entry.412766108" value="" class="ss-q-short" id="entry_412766108" dir="auto" aria-label="What is your first name? " aria-required="true" required="" title="">
<div class="error-message" id="1816684451_errorMessage"></div>
<div class="required-message">This is a required question</div>
</div></div></div> <div class="ss-form-question errorbox-good" role="listitem">
<div dir="ltr" class="ss-item ss-item-required ss-text"><div class="ss-form-entry">
<label class="ss-q-item-label" for="entry_631662558"><div class="ss-q-title">What is your last name?
<label for="itemView.getDomIdToLabel()" aria-label="(Required field)"></label>
<span class="ss-required-asterisk">*</span></div>
<div class="ss-q-help ss-secondary-text" dir="ltr"></div></label>
<input type="text" name="entry.631662558" value="" class="ss-q-short" id="entry_631662558" dir="auto" aria-label="What is your last name? " aria-required="true" required="" title="">
<div class="error-message" id="1499157186_errorMessage"></div>
<div class="required-message">This is a required question</div>
</div></div></div> <div class="ss-form-question errorbox-good" role="listitem">
<div dir="ltr" class="ss-item ss-text"><div class="ss-form-entry">
<label class="ss-q-item-label" for="entry_65623590"><div class="ss-q-title">If you have a preferred name, enter it here.
</div>
<div class="ss-q-help ss-secondary-text" dir="ltr"></div></label>
<input type="text" name="entry.65623590" value="" class="ss-q-short" id="entry_65623590" dir="auto" aria-label="If you have a preferred name, enter it here. " title="">
<div class="error-message" id="1675882950_errorMessage"></div>
<div class="required-message">This is a required question</div>
</div></div></div> <div class="ss-form-question errorbox-good" role="listitem">
<div dir="ltr" class="ss-item ss-item-required ss-date"><div class="ss-form-entry">
<label class="ss-q-item-label" for="entry_1254194880"><div class="ss-q-title">What is your date of birth?
<label for="itemView.getDomIdToLabel()" aria-label="(Required field)"></label>
<span class="ss-required-asterisk">*</span></div>
<div class="ss-q-help ss-secondary-text" dir="ltr"></div></label>
<input type="date" name="entry.1254194880" value="" class="ss-q-date" dir="auto" id="entry_1254194880" aria-label="What is your date of birth? " aria-required="true" required="">
<div class="required-message">This is a required question</div></div></div></div> <div class="ss-form-question errorbox-good" role="listitem">
<div dir="ltr" class="ss-item ss-item-required ss-paragraph-text"><div class="ss-form-entry">
<label class="ss-q-item-label" for="entry_995572488"><div class="ss-q-title">What is your residential Address?
<label for="itemView.getDomIdToLabel()" aria-label="(Required field)"></label>
<span class="ss-required-asterisk">*</span></div>
<div class="ss-q-help ss-secondary-text" dir="ltr">Number, street, suburb, and postcode.</div></label>
<textarea name="entry.995572488" rows="8" cols="0" class="ss-q-long" id="entry_995572488" dir="auto" aria-label="What is your residential Address? Number, street, suburb, and postcode. " aria-required="true" required=""></textarea>
<div class="error-message" id="1386447200_errorMessage"></div>
<div class="required-message">This is a required question</div>
</div></div></div> <div class="ss-form-question errorbox-good" role="listitem">
<div dir="ltr" class="ss-item ss-paragraph-text"><div class="ss-form-entry">
<label class="ss-q-item-label" for="entry_1263666193"><div class="ss-q-title">What is your postal address if different from above?
</div>
<div class="ss-q-help ss-secondary-text" dir="ltr"></div></label>
<textarea name="entry.1263666193" rows="8" cols="0" class="ss-q-long" id="entry_1263666193" dir="auto" aria-label="What is your postal address if different from above? "></textarea>
<div class="error-message" id="1804983443_errorMessage"></div>
<div class="required-message">This is a required question</div>
</div></div></div> <div class="ss-form-question errorbox-good" role="listitem">
<div dir="ltr" class="ss-item ss-item-required ss-radio"><div class="ss-form-entry">
<label class="ss-q-item-label" for="entry_1773874063"><div class="ss-q-title">Are you enrolled to vote in the ACT?
<label for="itemView.getDomIdToLabel()" aria-label="(Required field)"></label>
<span class="ss-required-asterisk">*</span></div>
<div class="ss-q-help ss-secondary-text" dir="ltr">Due to regulations, you must be enrolled in the ACT to be a member.</div></label>
<ul class="ss-choices" role="radiogroup" aria-label="Are you enrolled to vote in the ACT? Due to regulations, you must be enrolled in the ACT to be a member. "><li class="ss-choice-item"><label><span class="ss-choice-item-control goog-inline-block"><input type="radio" name="entry.1870444899" value="Yes" id="group_1870444899_1" role="radio" class="ss-q-radio" aria-label="Yes" required="" aria-required="true"></span>
<span class="ss-choice-label">Yes</span>
</label></li> <li class="ss-choice-item"><label><span class="ss-choice-item-control goog-inline-block"><input type="radio" name="entry.1870444899" value="No" id="group_1870444899_2" role="radio" class="ss-q-radio" aria-label="No" required="" aria-required="true"></span>
<span class="ss-choice-label">No</span>
</label></li></ul>
<div class="error-message" id="1773874063_errorMessage"></div>
<div class="required-message">This is a required question</div></div></div></div> <div class="ss-form-question errorbox-good" role="listitem">
<div dir="ltr" class="ss-item ss-text"><div class="ss-form-entry">
<label class="ss-q-item-label" for="entry_1577073812"><div class="ss-q-title">Mobile Number
</div>
<div class="ss-q-help ss-secondary-text" dir="ltr"></div></label>
<input type="text" name="entry.1577073812" value="" class="ss-q-short" id="entry_1577073812" dir="auto" aria-label="Mobile Number " title="">
<div class="error-message" id="437263411_errorMessage"></div>
<div class="required-message">This is a required question</div>
</div></div></div> <div class="ss-form-question errorbox-good" role="listitem">
<div dir="ltr" class="ss-item ss-text"><div class="ss-form-entry">
<label class="ss-q-item-label" for="entry_1854868369"><div class="ss-q-title">Home Number
</div>
<div class="ss-q-help ss-secondary-text" dir="ltr"></div></label>
<input type="text" name="entry.1854868369" value="" class="ss-q-short" id="entry_1854868369" dir="auto" aria-label="Home Number " title="">
<div class="error-message" id="775049203_errorMessage"></div>
<div class="required-message">This is a required question</div>
</div></div></div> <div class="ss-form-question errorbox-good" role="listitem">
<div dir="ltr" class="ss-item ss-text"><div class="ss-form-entry">
<label class="ss-q-item-label" for="entry_547995226"><div class="ss-q-title">Work Number
</div>
<div class="ss-q-help ss-secondary-text" dir="ltr"></div></label>
<input type="text" name="entry.547995226" value="" class="ss-q-short" id="entry_547995226" dir="auto" aria-label="Work Number " title="">
<div class="error-message" id="44689170_errorMessage"></div>
<div class="required-message">This is a required question</div>
</div></div></div> <div class="ss-form-question errorbox-good" role="listitem">
<div dir="ltr" class="ss-item ss-text"><div class="ss-form-entry">
<label class="ss-q-item-label" for="entry_126679684"><div class="ss-q-title">Email
</div>
<div class="ss-q-help ss-secondary-text" dir="ltr"></div></label>
<input type="text" name="entry.126679684" value="" class="ss-q-short" id="entry_126679684" dir="auto" aria-label="Email " title="">
<div class="error-message" id="502994458_errorMessage"></div>
<div class="required-message">This is a required question</div>
</div></div></div> <div class="ss-form-question errorbox-good" role="listitem">
<div dir="ltr" class="ss-item ss-text"><div class="ss-form-entry">
<label class="ss-q-item-label" for="entry_841767899"><div class="ss-q-title">Occupation
</div>
<div class="ss-q-help ss-secondary-text" dir="ltr"></div></label>
<input type="text" name="entry.841767899" value="" class="ss-q-short" id="entry_841767899" dir="auto" aria-label="Occupation " title="">
<div class="error-message" id="2087472922_errorMessage"></div>
<div class="required-message">This is a required question</div>
</div></div></div> <div class="ss-form-question errorbox-good" role="listitem">
<div dir="ltr" class="ss-item ss-item-required ss-select"><div class="ss-form-entry">
<label class="ss-q-item-label" for="entry_532126648"><div class="ss-q-title">Are you a member of a trade union?
<label for="itemView.getDomIdToLabel()" aria-label="(Required field)"></label>
<span class="ss-required-asterisk">*</span></div>
<div class="ss-q-help ss-secondary-text" dir="ltr"></div></label>
<select name="entry.532126648" id="entry_532126648" aria-label="Are you a member of a trade union? " aria-required="true" required=""><option value=""></option>
<option value="No">No</option> <option value="AMWU">AMWU</option> <option value="ASU">ASU</option> <option value="AWU">AWU</option> <option value="CEPU">CEPU</option> <option value="CPSU">CPSU</option> <option value="CFMEU">CFMEU</option> <option value="NUW">NUW</option> <option value="RTBU">RTBU</option> <option value="SDA">SDA</option> <option value="TWU">TWU</option> <option value="United Voice">United Voice</option> <option value="Other">Other</option></select>
<div class="required-message">This is a required question</div></div></div></div> <div class="ss-form-question errorbox-good" role="listitem">
<div dir="ltr" class="ss-item ss-item-required ss-radio"><div class="ss-form-entry">
<label class="ss-q-item-label" for="entry_1484222850"><div class="ss-q-title">Do you have a government concession or full-time student card?
<label for="itemView.getDomIdToLabel()" aria-label="(Required field)"></label>
<span class="ss-required-asterisk">*</span></div>
<div class="ss-q-help ss-secondary-text" dir="ltr"></div></label>
<ul class="ss-choices" role="radiogroup" aria-label="Do you have a government concession or full-time student card? "><li class="ss-choice-item"><label><span class="ss-choice-item-control goog-inline-block"><input type="radio" name="entry.540860717" value="Yes" id="group_540860717_1" role="radio" class="ss-q-radio" aria-label="Yes" required="" aria-required="true"></span>
<span class="ss-choice-label">Yes</span>
</label></li> <li class="ss-choice-item"><label><span class="ss-choice-item-control goog-inline-block"><input type="radio" name="entry.540860717" value="No" id="group_540860717_2" role="radio" class="ss-q-radio" aria-label="No" required="" aria-required="true"></span>
<span class="ss-choice-label">No</span>
</label></li></ul>
<div class="error-message" id="1484222850_errorMessage"></div>
<div class="required-message">This is a required question</div></div></div></div> <div class="ss-form-question errorbox-good" role="listitem">
<div dir="ltr" class="ss-item ss-item-required ss-checkbox"><div class="ss-form-entry">
<label class="ss-q-item-label" for="entry_1728110016"><div class="ss-q-title">Please tick the appropriate box for membership fees.
<label for="itemView.getDomIdToLabel()" aria-label="(Required field)"></label>
<span class="ss-required-asterisk">*</span></div>
<div class="ss-q-help ss-secondary-text" dir="ltr">Annual income with the membership fee in brackets</div></label>
<ul class="ss-choices ss-choices-required" role="group" aria-label="Please tick the appropriate box for membership fees. Annual income with the membership fee in brackets "><li class="ss-choice-item"><label><span class="ss-choice-item-control goog-inline-block"><input type="checkbox" name="entry.1067022385" value="$0-25,000 ($15.00)" id="group_1067022385_1" role="checkbox" class="ss-q-checkbox" aria-required="true"></span>
<span class="ss-choice-label">$0-25,000 ($15.00)</span>
</label></li> <li class="ss-choice-item"><label><span class="ss-choice-item-control goog-inline-block"><input type="checkbox" name="entry.1067022385" value="$25,001 - $50,000 ($35.00)" id="group_1067022385_2" role="checkbox" class="ss-q-checkbox" aria-required="true"></span>
<span class="ss-choice-label">$25,001 - $50,000 ($35.00)</span>
</label></li> <li class="ss-choice-item"><label><span class="ss-choice-item-control goog-inline-block"><input type="checkbox" name="entry.1067022385" value="$50,000 - $75,000 ($60)" id="group_1067022385_3" role="checkbox" class="ss-q-checkbox" aria-required="true"></span>
<span class="ss-choice-label">$50,000 - $75,000 ($60)</span>
</label></li> <li class="ss-choice-item"><label><span class="ss-choice-item-control goog-inline-block"><input type="checkbox" name="entry.1067022385" value="$75,001 - $100,000" id="group_1067022385_4" role="checkbox" class="ss-q-checkbox" aria-required="true"></span>
<span class="ss-choice-label">$75,001 - $100,000</span>
</label></li> <li class="ss-choice-item"><label><span class="ss-choice-item-control goog-inline-block"><input type="checkbox" name="entry.1067022385" value="Over $100,000" id="group_1067022385_5" role="checkbox" class="ss-q-checkbox" aria-required="true"></span>
<span class="ss-choice-label">Over $100,000</span>
</label></li></ul>
<div class="error-message" id="1728110016_errorMessage"></div>
<div class="required-message">This is a required question</div></div></div></div> <div class="ss-form-question errorbox-good" role="listitem">
<div dir="ltr" class="ss-item ss-checkbox"><div class="ss-form-entry">
<label class="ss-q-item-label" for="entry_200755059"><div class="ss-q-title">Discounts Avaliable
</div>
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