{"id":569,"date":"2016-09-07T10:35:59","date_gmt":"2016-09-07T14:35:59","guid":{"rendered":"http:\/\/mccdemosite1.devsiteurl.com\/career-services\/?page_id=569"},"modified":"2017-09-13T13:09:18","modified_gmt":"2017-09-13T17:09:18","slug":"service-learning-program","status":"publish","type":"page","link":"https:\/\/mccdemosite1.devsiteurl.com\/career-services\/service-learning-program\/","title":{"rendered":"Middlesex County College Service Learning Partner Survey"},"content":{"rendered":"<p>Middlesex County College is committed to our service learning initiative and in partnering with local organizations.  Kindly complete the requested fields, so that we can best help you meet your community needs.<br \/>\n<div class=\"frm_forms  with_frm_style frm_style_formidable-style\" id=\"frm_form_5_container\" >\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_pro_form \" id=\"form_tiayu\"  >\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_hidden\">Service Learning Program<\/legend>\r\n\r\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"5\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_5\" id=\"frm_hide_fields_5\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"tiayu\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_5\" name=\"frm_submit_entry_5\" value=\"e9c9547924\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/career-services\/wp-json\/wp\/v2\/pages\/569\" \/><input type=\"text\" class=\"frm_hidden frm_verify\" id=\"frm_verify_5\" name=\"frm_verify\" value=\"\"  \/>\n\n<div id=\"frm_field_98_container\" class=\"frm_form_field  frm_top_container frm_html_container form-field\"><span style=\"color: #ff0000;\">*<\/span> indicates that this is a required field<\/p>\n<h3>ABOUT YOUR ORGANIZATION <\/h3>\n<\/div>\n<div id=\"frm_field_63_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_iakys\" class=\"frm_primary_label\">Organization Name :\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_iakys\" name=\"item_meta[63]\" value=\"\"  data-reqmsg=\"This field cannot be blank.\"  \/>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_65_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_op8l3\" class=\"frm_primary_label\">Industry Type :\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[65]\" id=\"field_op8l3\"  data-frmval=\"Faith-Based Organization\" data-reqmsg=\"This field cannot be blank.\"  >\n\t\t\t<option value=\"Faith-Based Organization\"  selected=\"selected\">Faith-Based Organization<\/option>\n\t\t\t\t<option value=\"Public Service\/Public Interest\" >Public Service\/Public Interest<\/option>\n\t\t\t\t<option value=\"Neighborhood Association\" >Neighborhood Association<\/option>\n\t\t\t\t<option value=\"Voter Registration\" >Voter Registration<\/option>\n\t\t\t\t<option value=\"Political Campaign\" >Political Campaign<\/option>\n\t\t\t\t<option value=\"Community-Based\" >Community-Based<\/option>\n\t\t\t\t<option value=\"Mentorship\/Tutoring\" >Mentorship\/Tutoring<\/option>\n\t\t\t\t<option value=\"Conservation\" >Conservation<\/option>\n\t\t\t\t<option value=\"Environmental\" >Environmental<\/option>\n\t\t\t\t<option value=\"Other\" >Other<\/option>\n\t\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_66_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_4i1sf\" class=\"frm_primary_label\">Street Address :\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_4i1sf\" name=\"item_meta[66]\" value=\"\"  data-reqmsg=\"This field cannot be blank.\"  \/>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_67_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_ngbfr\" class=\"frm_primary_label\">City :\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_ngbfr\" name=\"item_meta[67]\" value=\"\"  data-reqmsg=\"This field cannot be blank.\"  \/>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_99_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_64tw8\" class=\"frm_primary_label\">State :\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[99]\" id=\"field_64tw8\"  data-frmval=\"Alabama\" data-reqmsg=\"This field cannot be blank.\"  >\n\t\t\t<option value=\"Alabama\"  selected=\"selected\">Alabama<\/option>\n\t\t\t\t<option value=\"Alaska\" >Alaska<\/option>\n\t\t\t\t<option value=\"Arizona\" >Arizona<\/option>\n\t\t\t\t<option value=\"Arkansas\" >Arkansas<\/option>\n\t\t\t\t<option value=\"California\" >California<\/option>\n\t\t\t\t<option value=\"Colorado\" >Colorado<\/option>\n\t\t\t\t<option value=\"Connecticut\" >Connecticut<\/option>\n\t\t\t\t<option value=\"Delaware\" >Delaware<\/option>\n\t\t\t\t<option value=\"District of Columbia\" >District of Columbia<\/option>\n\t\t\t\t<option value=\"Florida\" >Florida<\/option>\n\t\t\t\t<option value=\"Georgia\" >Georgia<\/option>\n\t\t\t\t<option value=\"Hawaii\" >Hawaii<\/option>\n\t\t\t\t<option value=\"Idaho\" >Idaho<\/option>\n\t\t\t\t<option value=\"Illinois\" >Illinois<\/option>\n\t\t\t\t<option value=\"Indiana\" >Indiana<\/option>\n\t\t\t\t<option value=\"Iowa\" >Iowa<\/option>\n\t\t\t\t<option value=\"Kansas\" >Kansas<\/option>\n\t\t\t\t<option value=\"Kentucky\" >Kentucky<\/option>\n\t\t\t\t<option value=\"Louisiana\" >Louisiana<\/option>\n\t\t\t\t<option value=\"Maine\" >Maine<\/option>\n\t\t\t\t<option value=\"Maryland\" >Maryland<\/option>\n\t\t\t\t<option value=\"Massachusetts\" >Massachusetts<\/option>\n\t\t\t\t<option value=\"Michigan\" >Michigan<\/option>\n\t\t\t\t<option value=\"Minnesota\" >Minnesota<\/option>\n\t\t\t\t<option value=\"Mississippi\" >Mississippi<\/option>\n\t\t\t\t<option value=\"Missouri\" >Missouri<\/option>\n\t\t\t\t<option value=\"Montana\" >Montana<\/option>\n\t\t\t\t<option value=\"Nebraska\" >Nebraska<\/option>\n\t\t\t\t<option value=\"Nevada\" >Nevada<\/option>\n\t\t\t\t<option value=\"New Hampshire\" >New Hampshire<\/option>\n\t\t\t\t<option value=\"New Jersey\" >New Jersey<\/option>\n\t\t\t\t<option value=\"New Mexico\" >New Mexico<\/option>\n\t\t\t\t<option value=\"New York\" >New York<\/option>\n\t\t\t\t<option value=\"North Carolina\" >North Carolina<\/option>\n\t\t\t\t<option value=\"North Dakota\" >North Dakota<\/option>\n\t\t\t\t<option value=\"Ohio\" >Ohio<\/option>\n\t\t\t\t<option value=\"Oklahoma\" >Oklahoma<\/option>\n\t\t\t\t<option value=\"Oregon\" >Oregon<\/option>\n\t\t\t\t<option value=\"Pennsylvania\" >Pennsylvania<\/option>\n\t\t\t\t<option value=\"Rhode Island\" >Rhode Island<\/option>\n\t\t\t\t<option value=\"South Carolina\" >South Carolina<\/option>\n\t\t\t\t<option value=\"South Dakota\" >South Dakota<\/option>\n\t\t\t\t<option value=\"Tennessee\" >Tennessee<\/option>\n\t\t\t\t<option value=\"Texas\" >Texas<\/option>\n\t\t\t\t<option value=\"Utah\" >Utah<\/option>\n\t\t\t\t<option value=\"Vermont\" >Vermont<\/option>\n\t\t\t\t<option value=\"Virginia\" >Virginia<\/option>\n\t\t\t\t<option value=\"Washington\" >Washington<\/option>\n\t\t\t\t<option value=\"West Virginia\" >West Virginia<\/option>\n\t\t\t\t<option value=\"Wisconsin\" >Wisconsin<\/option>\n\t\t\t\t<option value=\"Wyoming\" >Wyoming<\/option>\n\t\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_69_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_g8xwe\" class=\"frm_primary_label\">Web URL :\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_g8xwe\" name=\"item_meta[69]\" value=\"\"  data-reqmsg=\"This field cannot be blank.\"  \/>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_70_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_3hy3j\" class=\"frm_primary_label\">Contact Person :\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_3hy3j\" name=\"item_meta[70]\" value=\"\"  data-reqmsg=\"This field cannot be blank.\"  \/>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_71_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_zim27\" class=\"frm_primary_label\">Contact Phone Number :\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_zim27\" name=\"item_meta[71]\" value=\"\"  data-reqmsg=\"This field cannot be blank.\"  \/>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_72_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_xafvu\" class=\"frm_primary_label\">Alternate Contact Phone Number :\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_xafvu\" name=\"item_meta[72]\" value=\"\"    \/>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_73_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_l0qod\" class=\"frm_primary_label\">Contact Email Address :\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_l0qod\" name=\"item_meta[73]\" value=\"\"  data-reqmsg=\"This field cannot be blank.\"  \/>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_74_container\" class=\"frm_form_field  frm_top_container frm_html_container form-field\"><label for=\"field_mpve1\" class=\"frm_primary_label\">What are your hours of operation?<\/label><\/div>\n<div id=\"frm_field_106_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_half\">\r\n    <label for=\"field_ld3m5\" class=\"frm_primary_label\">From :\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_ld3m5\" name=\"item_meta[106]\" value=\"\"  data-reqmsg=\"This field cannot be blank.\"  \/>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_96_container\" class=\"frm_form_field form-field  frm_required_field frm_hidden_container frm_half\">\r\n    <label for=\"field_yoiq6\" class=\"frm_primary_label\">\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[96]\" id=\"field_yoiq6\"  data-frmval=\"AM\" data-reqmsg=\"This field cannot be blank.\"  >\n\t\t\t<option value=\"AM\"  selected=\"selected\">AM<\/option>\n\t\t\t\t<option value=\"PM\" >PM<\/option>\n\t\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_107_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_half\">\r\n    <label for=\"field_6quyd\" class=\"frm_primary_label\">To:\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_6quyd\" name=\"item_meta[107]\" value=\"\"  data-reqmsg=\"This field cannot be blank.\"  \/>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_97_container\" class=\"frm_form_field form-field  frm_required_field frm_hidden_container frm_half\">\r\n    <label for=\"field_rnmpi\" class=\"frm_primary_label\">\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[97]\" id=\"field_rnmpi\"  data-frmval=\"AM\" data-reqmsg=\"This field cannot be blank.\"  >\n\t\t\t<option value=\"AM\"  selected=\"selected\">AM<\/option>\n\t\t\t\t<option value=\"PM\" >PM<\/option>\n\t\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_77_container\" class=\"frm_form_field  frm_top_container frm_html_container form-field\">\n<h3>SERVICE LEARNING OPPORTUNITY<\/h3>\n<\/div>\n<div id=\"frm_field_78_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_qi55k\" class=\"frm_primary_label\">Tell us about your service learning opportunity. What specific aspect of this opportunity will be considered service learning (civic engagement)? :\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[78]\" id=\"field_qi55k\"  data-reqmsg=\"This field cannot be blank.\"  ><\/textarea>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_79_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_64ext\" class=\"frm_primary_label\">Where will the actual service learning work be performed? Indicate the city :\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_64ext\" name=\"item_meta[79]\" value=\"\"  data-reqmsg=\"This field cannot be blank.\"  \/>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_80_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_btee0\" class=\"frm_primary_label\">What Middlesex County College majors would align with your organization goals? <br> (Select all that apply - up to 5 majors)\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[80][]\" id=\"field_btee0\"  multiple=\"multiple\"  data-placeholder=\" \" data-reqmsg=\"This field cannot be blank.\" class=\"frm_chzn\"  >\n\t\t\t<option value=\"Accounting\" >Accounting<\/option>\n\t\t\t\t<option value=\"Addiction Studies\" >Addiction Studies<\/option>\n\t\t\t\t<option value=\"Advertising Graphic Design\" >Advertising Graphic Design<\/option>\n\t\t\t\t<option value=\"Allied Health Pre-Professional\" >Allied Health Pre-Professional<\/option>\n\t\t\t\t<option value=\"Automotive Technology\" >Automotive Technology<\/option>\n\t\t\t\t<option value=\"Baking and Pastry Arts\" >Baking and Pastry Arts<\/option>\n\t\t\t\t<option value=\"Biology\" >Biology<\/option>\n\t\t\t\t<option value=\"Biotechnology\" >Biotechnology<\/option>\n\t\t\t\t<option value=\"Business Administration\" >Business Administration<\/option>\n\t\t\t\t<option value=\"Chemistry\" >Chemistry<\/option>\n\t\t\t\t<option value=\"Civil Engineering Technology\" >Civil Engineering Technology<\/option>\n\t\t\t\t<option value=\"Computer Aided Drafting\" >Computer Aided Drafting<\/option>\n\t\t\t\t<option value=\"Computer and Information Systems\" >Computer and Information Systems<\/option>\n\t\t\t\t<option value=\"Computer Help Desk Administration\" >Computer Help Desk Administration<\/option>\n\t\t\t\t<option value=\"Computer Programming\" >Computer Programming<\/option>\n\t\t\t\t<option value=\"Criminal Justice - Correction Administration\" >Criminal Justice - Correction Administration<\/option>\n\t\t\t\t<option value=\"Criminal Justice - Police Science\" >Criminal Justice - Police Science<\/option>\n\t\t\t\t<option value=\"Culinary Arts Management\" >Culinary Arts Management<\/option>\n\t\t\t\t<option value=\"Cyber Security\" >Cyber Security<\/option>\n\t\t\t\t<option value=\"Dental Hygiene\" >Dental Hygiene<\/option>\n\t\t\t\t<option value=\"Dietetics\" >Dietetics<\/option>\n\t\t\t\t<option value=\"Earth Science\" >Earth Science<\/option>\n\t\t\t\t<option value=\"Education\" >Education<\/option>\n\t\t\t\t<option value=\"Electrical Engineering Technology\" >Electrical Engineering Technology<\/option>\n\t\t\t\t<option value=\"Engineering Science\" >Engineering Science<\/option>\n\t\t\t\t<option value=\"Event Planning Management\" >Event Planning Management<\/option>\n\t\t\t\t<option value=\"Fashion Merchandising and Retail Management\" >Fashion Merchandising and Retail Management<\/option>\n\t\t\t\t<option value=\"Fire Science Technology\" >Fire Science Technology<\/option>\n\t\t\t\t<option value=\"Forensic Accounting and Fraud Examination\" >Forensic Accounting and Fraud Examination<\/option>\n\t\t\t\t<option value=\"Gaming and Animation\" >Gaming and Animation<\/option>\n\t\t\t\t<option value=\"Health Science\" >Health Science<\/option>\n\t\t\t\t<option value=\"Hotel\/Motel Management\" >Hotel\/Motel Management<\/option>\n\t\t\t\t<option value=\"Java and Web Programming\" >Java and Web Programming<\/option>\n\t\t\t\t<option value=\"African-American Studies\" >African-American Studies<\/option>\n\t\t\t\t<option value=\"Cinema Studies\" >Cinema Studies<\/option>\n\t\t\t\t<option value=\"Communication\" >Communication<\/option>\n\t\t\t\t<option value=\"Dance\" >Dance<\/option>\n\t\t\t\t<option value=\"English\" >English<\/option>\n\t\t\t\t<option value=\"Genocide and the Holocaust\" >Genocide and the Holocaust<\/option>\n\t\t\t\t<option value=\"Global Studies\" >Global Studies<\/option>\n\t\t\t\t<option value=\"History\" >History<\/option>\n\t\t\t\t<option value=\"Journalism\" >Journalism<\/option>\n\t\t\t\t<option value=\"Music\" >Music<\/option>\n\t\t\t\t<option value=\"Philosophy\" >Philosophy<\/option>\n\t\t\t\t<option value=\"Physical Education\/Recreation\" >Physical Education\/Recreation<\/option>\n\t\t\t\t<option value=\"Political Science\" >Political Science<\/option>\n\t\t\t\t<option value=\"Psychology\" >Psychology<\/option>\n\t\t\t\t<option value=\"Social and Rehabilitation Services\" >Social and Rehabilitation Services<\/option>\n\t\t\t\t<option value=\"Social Sciences\" >Social Sciences<\/option>\n\t\t\t\t<option value=\"Sociology\" >Sociology<\/option>\n\t\t\t\t<option value=\"Theatre\" >Theatre<\/option>\n\t\t\t\t<option value=\"Writing\" >Writing<\/option>\n\t\t\t\t<option value=\"Management\" >Management<\/option>\n\t\t\t\t<option value=\"Marketing\" >Marketing<\/option>\n\t\t\t\t<option value=\"Mathematics\" >Mathematics<\/option>\n\t\t\t\t<option value=\"Mechanical Engineering Technology\" >Mechanical Engineering Technology<\/option>\n\t\t\t\t<option value=\"Media Arts and Design\" >Media Arts and Design<\/option>\n\t\t\t\t<option value=\"Medical Laboratory Technology\" >Medical Laboratory Technology<\/option>\n\t\t\t\t<option value=\"Network Administration and Support\" >Network Administration and Support<\/option>\n\t\t\t\t<option value=\"Nursing\" >Nursing<\/option>\n\t\t\t\t<option value=\"Paralegal Studies\" >Paralegal Studies<\/option>\n\t\t\t\t<option value=\"Photography, Professional Commercial\" >Photography, Professional Commercial<\/option>\n\t\t\t\t<option value=\"Physics\" >Physics<\/option>\n\t\t\t\t<option value=\"Process Technology\" >Process Technology<\/option>\n\t\t\t\t<option value=\"Psychosocial Rehabilitation and Treatment\" >Psychosocial Rehabilitation and Treatment<\/option>\n\t\t\t\t<option value=\"Public Health\" >Public Health<\/option>\n\t\t\t\t<option value=\"Radiography\" >Radiography<\/option>\n\t\t\t\t<option value=\"Restaurant Operations\" >Restaurant Operations<\/option>\n\t\t\t\t<option value=\"Restaurant\/Food Service Management\" >Restaurant\/Food Service Management<\/option>\n\t\t\t\t<option value=\"Small Business Management\/Entrepreneurial Studies\" >Small Business Management\/Entrepreneurial Studies<\/option>\n\t\t\t\t<option value=\"Surveying Engineering Technology\" >Surveying Engineering Technology<\/option>\n\t\t\t\t<option value=\"Windows\/PC Support\" >Windows\/PC Support<\/option>\n\t\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_81_container\" class=\"frm_form_field  frm_top_container frm_html_container form-field\"><label for=\"field_mpve1\" class=\"frm_primary_label\">What semester can you accept students?<\/label><\/div>\n<div id=\"frm_field_82_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_half\">\r\n    <label for=\"field_70vho\" class=\"frm_primary_label\">Semester :\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[82]\" id=\"field_70vho\"  data-reqmsg=\"This field cannot be blank.\"  >\n\t\t\t<option value=\"\"  selected=\"selected\"> <\/option>\n\t\t\t\t<option value=\"Fall\" >Fall<\/option>\n\t\t\t\t<option value=\"Spring\" >Spring<\/option>\n\t\t\t\t<option value=\"Winter\" >Winter<\/option>\n\t\t\t\t<option value=\"Summer\" >Summer<\/option>\n\t\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_83_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_half\">\r\n    <label for=\"field_j1dda\" class=\"frm_primary_label\">Year :\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[83]\" id=\"field_j1dda\"  data-reqmsg=\"This field cannot be blank.\"  >\n\t\t\t<option value=\"\"  selected=\"selected\"> <\/option>\n\t\t\t\t<option value=\"2016\" >2016<\/option>\n\t\t\t\t<option value=\"2017\" >2017<\/option>\n\t\t\t\t<option value=\"2018\" >2018<\/option>\n\t\t\t\t<option value=\"2019\" >2019<\/option>\n\t\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_84_container\" class=\"frm_form_field  frm_top_container frm_html_container form-field\"><label for=\"field_mpve1\" class=\"frm_primary_label\">What hours can you accept students or would like students to perform the service learning? <\/label><\/div>\n<div id=\"frm_field_108_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_half\">\r\n    <label for=\"field_kkqt1\" class=\"frm_primary_label\">From :\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_kkqt1\" name=\"item_meta[108]\" value=\"\"  data-reqmsg=\"This field cannot be blank.\"  \/>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_109_container\" class=\"frm_form_field form-field  frm_required_field frm_hidden_container frm_half\">\r\n    <label for=\"field_b8dzu\" class=\"frm_primary_label\">\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[109]\" id=\"field_b8dzu\"  data-frmval=\"AM\" data-reqmsg=\"This field cannot be blank.\"  >\n\t\t\t<option value=\"AM\"  selected=\"selected\">AM<\/option>\n\t\t\t\t<option value=\"PM\" >PM<\/option>\n\t\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_110_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_half\">\r\n    <label for=\"field_4hud8\" class=\"frm_primary_label\">To:\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_4hud8\" name=\"item_meta[110]\" value=\"\"  data-reqmsg=\"This field cannot be blank.\"  \/>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_111_container\" class=\"frm_form_field form-field  frm_required_field frm_hidden_container frm_half\">\r\n    <label for=\"field_g9fxq\" class=\"frm_primary_label\">\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[111]\" id=\"field_g9fxq\"  data-frmval=\"AM\" data-reqmsg=\"This field cannot be blank.\"  >\n\t\t\t<option value=\"AM\"  selected=\"selected\">AM<\/option>\n\t\t\t\t<option value=\"PM\" >PM<\/option>\n\t\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_112_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_aucno\" class=\"frm_primary_label\">How many students can you accept for the specified semester and year?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_aucno\" name=\"item_meta[112]\" value=\"\"    \/>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_88_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_eradd\" class=\"frm_primary_label\">What day of the week can you accept students or would like students to perform the service learning?\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[88][]\" id=\"field_eradd\"  multiple=\"multiple\"  data-placeholder=\" \" data-reqmsg=\"This field cannot be blank.\" class=\"frm_chzn\"  >\n\t\t\t<option value=\"\"  selected=\"selected\"> <\/option>\n\t\t\t\t<option value=\"Monday\" >Monday<\/option>\n\t\t\t\t<option value=\"Tuesday\" >Tuesday<\/option>\n\t\t\t\t<option value=\"Wednesday\" >Wednesday<\/option>\n\t\t\t\t<option value=\"Thursday\" >Thursday<\/option>\n\t\t\t\t<option value=\"Friday\" >Friday<\/option>\n\t\t\t\t<option value=\"Saturday\" >Saturday<\/option>\n\t\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_102_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_b2wvq\" class=\"frm_primary_label\">Is your organization accessible by public transportation? :\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[102]\" id=\"field_b2wvq\"  data-frmval=\"Yes\" data-reqmsg=\"This field cannot be blank.\"  >\n\t\t\t<option value=\"Yes\"  selected=\"selected\">Yes<\/option>\n\t\t\t\t<option value=\"No\" >No<\/option>\n\t\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_91_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label  class=\"frm_primary_label\">Will you be supervising our students(s)?\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t\t<div class=\"frm_radio\"><label for=\"field_qyba3-0\">            <input type=\"radio\" name=\"item_meta[91]\" id=\"field_qyba3-0\" value=\"Yes\"   data-reqmsg=\"This field cannot be blank.\"  \/> Yes<\/label><\/div>\n\t\t\t<div class=\"frm_radio\"><label for=\"field_qyba3-1\">            <input type=\"radio\" name=\"item_meta[91]\" id=\"field_qyba3-1\" value=\"No\"   data-reqmsg=\"This field cannot be blank.\"  \/> No<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_100_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_3aapf\" class=\"frm_primary_label\">Name :\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_3aapf\" name=\"item_meta[100]\" value=\"\"  data-reqmsg=\"This field cannot be blank.\"  \/>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_101_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_3xpvt\" class=\"frm_primary_label\">Phone Number :\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_3xpvt\" name=\"item_meta[101]\" value=\"\"  data-reqmsg=\"This field cannot be blank.\"  \/>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_92_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label  class=\"frm_primary_label\">Do you prefer to interview students prior to the start of their service learning experience?\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<select name=\"item_meta[92]\" id=\"field_mb9me\"  data-frmval=\"Yes\" data-reqmsg=\"This field cannot be blank.\"  >\n\t\t\t<option value=\"Yes\"  selected=\"selected\">Yes<\/option>\n\t\t\t\t<option value=\"No\" >No<\/option>\n\t\t\t<\/select>\n\t<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_93_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_whwbp\" class=\"frm_primary_label\">Message or Note\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[93]\" id=\"field_whwbp\" rows=\"5\"    ><\/textarea>\n\r\n    \r\n    \r\n<\/div>\n<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n<div id=\"frm_field_cptch_number_container\" class=\"form-field frm_top_container auto_width\"><label class=\"frm_primary_label\">Confirm that you are human by answering this question <span class=\"frm_required\">*<\/span><\/label><script class=\"cptch_to_remove\">\r\n\t\t\t\t(function( timeout ) {\r\n\t\t\t\t\tsetTimeout(\r\n\t\t\t\t\t\tfunction() {\r\n\t\t\t\t\t\t\tvar notice = document.getElementById(\"cptch_time_limit_notice_52\");\r\n\t\t\t\t\t\t\tif ( notice )\r\n\t\t\t\t\t\t\t\tnotice.style.display = \"block\";\r\n\t\t\t\t\t\t},\r\n\t\t\t\t\t\ttimeout\r\n\t\t\t\t\t);\r\n\t\t\t\t})(120000);\r\n\t\t\t<\/script>\r\n\t\t\t<span id=\"cptch_time_limit_notice_52\" class=\"cptch_time_limit_notice cptch_to_remove\">Time limit is exhausted. Please reload CAPTCHA.<\/span><span class=\"cptch_wrap cptch_math_actions\">\r\n\t\t\t\t<label class=\"cptch_label\" for=\"cptch_input_52\"><span class=\"cptch_span\">s&#105;&#120;<\/span>\r\n\t\t\t\t\t<span class=\"cptch_span\">&nbsp;&times;&nbsp;<\/span>\r\n\t\t\t\t\t<span class=\"cptch_span\"><input id=\"cptch_input_52\" class=\"cptch_input \" type=\"text\" autocomplete=\"off\" name=\"cptch_number\" value=\"\" maxlength=\"2\" size=\"2\" aria-required=\"true\" required=\"required\" style=\"margin-bottom:0;display:inline;font-size: 12px;width: 40px;\" \/><\/span>\r\n\t\t\t\t\t<span class=\"cptch_span\">&nbsp;=&nbsp;<\/span>\r\n\t\t\t\t\t<span class=\"cptch_span\">&#116;h&#105;r&#116;y &#115;ix<\/span>\r\n\t\t\t\t\t<input type=\"hidden\" name=\"cptch_result\" value=\"9dA=\" \/><input type=\"hidden\" name=\"cptch_time\" value=\"1777745430\" \/>\r\n\t\t\t\t\t<input type=\"hidden\" name=\"cptch_form\" value=\"general\" \/>\r\n\t\t\t\t<\/label><span class=\"cptch_reload_button_wrap hide-if-no-js\">\r\n\t\t\t\t\t<noscript>\r\n\t\t\t\t\t\t<style type=\"text\/css\">\r\n\t\t\t\t\t\t\t.hide-if-no-js {\r\n\t\t\t\t\t\t\t\tdisplay: none !important;\r\n\t\t\t\t\t\t\t}\r\n\t\t\t\t\t\t<\/style>\r\n\t\t\t\t\t<\/noscript>\r\n\t\t\t\t\t<span class=\"cptch_reload_button dashicons dashicons-update\"><\/span>\r\n\t\t\t\t<\/span><\/span><\/div><div class=\"frm_submit\">\r\n\r\n<input type=\"submit\" value=\"Submit\"  class=\"frm_final_submit\" \/>\r\n<img decoding=\"async\" class=\"frm_ajax_loading\" src=\"https:\/\/mccdemosite1.devsiteurl.com\/career-services\/wp-content\/plugins\/formidable\/images\/ajax_loader.gif\" alt=\"Sending\"\/>\r\n\r\n<\/div><\/fieldset>\n<\/div>\n<\/form>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>Middlesex County College is committed to our service learning initiative and in partnering with local organizations. Kindly complete the requested fields, so that we can best help you meet your community needs.<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-569","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/mccdemosite1.devsiteurl.com\/career-services\/wp-json\/wp\/v2\/pages\/569","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mccdemosite1.devsiteurl.com\/career-services\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/mccdemosite1.devsiteurl.com\/career-services\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/mccdemosite1.devsiteurl.com\/career-services\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/mccdemosite1.devsiteurl.com\/career-services\/wp-json\/wp\/v2\/comments?post=569"}],"version-history":[{"count":11,"href":"https:\/\/mccdemosite1.devsiteurl.com\/career-services\/wp-json\/wp\/v2\/pages\/569\/revisions"}],"predecessor-version":[{"id":595,"href":"https:\/\/mccdemosite1.devsiteurl.com\/career-services\/wp-json\/wp\/v2\/pages\/569\/revisions\/595"}],"wp:attachment":[{"href":"https:\/\/mccdemosite1.devsiteurl.com\/career-services\/wp-json\/wp\/v2\/media?parent=569"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}