{"id":493,"date":"2016-02-23T17:47:35","date_gmt":"2016-02-23T22:47:35","guid":{"rendered":"http:\/\/www.jrccfurnituredepot.org\/?page_id=493"},"modified":"2024-02-05T15:42:32","modified_gmt":"2024-02-05T20:42:32","slug":"agency-booking","status":"publish","type":"page","link":"https:\/\/www.jrccfurnituredepot.org\/ru\/agencies\/agency-booking\/","title":{"rendered":"SET AN APPOINTMENT"},"content":{"rendered":"<p><strong>* From time to time we experience high demand, and our client calendar may be fully booked. <\/strong><strong>If there are no available dates on the calendar, kindly check for availability again the following morning.<\/strong><br \/>\n<strong>Thank you for your cooperation and support.<\/strong><\/p>\n<p><!--<a href=\"https:\/\/www.jrccfurnituredepot.org\/appointment-availability\/\" target=\"_blank\" rel=\"noopener noreferrer\">Click here to check availability<\/a>--><\/p>\n<div style=\"display:none\" class=\"fm-form-container fm-theme53\"><div id=\"fm-pages60\" class=\"fm-pages wdform_page_navigation \" show_title=\"false\" show_numbers=\"true\" type=\"none\"><\/div><form name=\"form60\" action=\"\/ru\/wp-json\/wp\/v2\/pages\/493\" method=\"post\" id=\"form60\" class=\"fm-form form60  \" enctype=\"multipart\/form-data\"><input type=\"hidden\" id=\"fm_page_id60\" value=\"493\" name=\"fm_page_id60\" \/><input type=\"hidden\" id=\"fm_current_post_type60\" value=\"page\" name=\"fm_current_post_type60\" \/><input type=\"hidden\" id=\"counter60\" value=\"59\" name=\"counter60\" \/><input type=\"hidden\" id=\"Itemid60\" value=\"\" name=\"Itemid60\" \/><input type=\"hidden\" id=\"fm_shake60\" value=\"1\" name=\"fm_shake60\" \/><input type=\"text\" class=\"fm-hide\" id=\"fm_empty_field_validation60\" value=\"\" name=\"fm_empty_field_validation60\" data-value=\"bd736efb144d599cf463541431fbf5c4\" \/><div class=\"wdform-page-and-images fm-form-builder\" style=\"border-top-color: black; border-top-width: 0px; border-top-style: solid; display: table;\"><div class=\"wdform_page\" id=\"60form_view1\" page_title=\"JRCC Furniture Depot Client Booking\" next_title=\"Next\" next_type=\"text\" next_class=\"wdform-page-button\" next_checkable=\"true\" previous_title=\"Previous\" previous_type=\"text\" previous_class=\"wdform-page-button\" previous_checkable=\"false\"><div class=\"wdform_section fm-col-1\"><div class=\"wdform_column\"><div wdid=\"58\" class=\"wdform_row\" style=\"position: relative; left: 0px; top: 0px;\"><div type=\"type_own_select\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_own_select\" ><div class=\"wdform-label-section wd-width-100 wdform_select wd-flex-row\">    <label  for=\"wdform_58_element60\" class=\"wdform-label\">Select a Date and Time Slot<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex wdform_select wd-flex-row wd-width-100\" ><select class=\"wd-width-100\" id=\"wdform_58_element60\" name=\"wdform_58_element60\" ><option value=\"\" selected=\"selected\"><\/option><option value=\"Wednesday 22 April, 2026 - 09:00AM\" >Wednesday 22 April, 2026 - 09:00AM<\/option><option value=\"Thursday 23 April, 2026 - 09:00AM\" >Thursday 23 April, 2026 - 09:00AM<\/option><option value=\"Thursday 23 April, 2026 - 10:00AM\" >Thursday 23 April, 2026 - 10:00AM<\/option><option value=\"Thursday 23 April, 2026 - 11:00AM\" >Thursday 23 April, 2026 - 11:00AM<\/option><option value=\"Thursday 23 April, 2026 - 12:00PM\" >Thursday 23 April, 2026 - 12:00PM<\/option><option value=\"Friday 24 April, 2026 - 09:00AM\" >Friday 24 April, 2026 - 09:00AM<\/option><option value=\"Monday 27 April, 2026 - 09:00AM\" >Monday 27 April, 2026 - 09:00AM<\/option><option value=\"Monday 27 April, 2026 - 10:00AM\" >Monday 27 April, 2026 - 10:00AM<\/option><option value=\"Monday 27 April, 2026 - 11:00AM\" >Monday 27 April, 2026 - 11:00AM<\/option><option value=\"Tuesday 28 April, 2026 - 09:00AM\" >Tuesday 28 April, 2026 - 09:00AM<\/option><option value=\"Tuesday 28 April, 2026 - 10:00AM\" >Tuesday 28 April, 2026 - 10:00AM<\/option><option value=\"Tuesday 28 April, 2026 - 11:00AM\" >Tuesday 28 April, 2026 - 11:00AM<\/option><option value=\"Wednesday 29 April, 2026 - 09:00AM\" >Wednesday 29 April, 2026 - 09:00AM<\/option><option value=\"Wednesday 29 April, 2026 - 10:00AM\" >Wednesday 29 April, 2026 - 10:00AM<\/option><option value=\"Wednesday 29 April, 2026 - 11:00AM\" >Wednesday 29 April, 2026 - 11:00AM<\/option><option value=\"Wednesday 29 April, 2026 - 12:00PM\" >Wednesday 29 April, 2026 - 12:00PM<\/option><option value=\"Thursday 30 April, 2026 - 09:00AM\" >Thursday 30 April, 2026 - 09:00AM<\/option><option value=\"Thursday 30 April, 2026 - 10:00AM\" >Thursday 30 April, 2026 - 10:00AM<\/option><option value=\"Thursday 30 April, 2026 - 11:00AM\" >Thursday 30 April, 2026 - 11:00AM<\/option><option value=\"Thursday 30 April, 2026 - 12:00PM\" >Thursday 30 April, 2026 - 12:00PM<\/option><option value=\"Friday 01 May, 2026 - 09:00AM\" >Friday 01 May, 2026 - 09:00AM<\/option><option value=\"Friday 01 May, 2026 - 10:00AM\" >Friday 01 May, 2026 - 10:00AM<\/option><option value=\"Monday 04 May, 2026 - 09:00AM\" >Monday 04 May, 2026 - 09:00AM<\/option><option value=\"Monday 04 May, 2026 - 10:00AM\" >Monday 04 May, 2026 - 10:00AM<\/option><option value=\"Monday 04 May, 2026 - 11:00AM\" >Monday 04 May, 2026 - 11:00AM<\/option><option value=\"Monday 04 May, 2026 - 12:00PM\" >Monday 04 May, 2026 - 12:00PM<\/option><option value=\"Tuesday 05 May, 2026 - 09:00AM\" >Tuesday 05 May, 2026 - 09:00AM<\/option><option value=\"Tuesday 05 May, 2026 - 10:00AM\" >Tuesday 05 May, 2026 - 10:00AM<\/option><option value=\"Tuesday 05 May, 2026 - 11:00AM\" >Tuesday 05 May, 2026 - 11:00AM<\/option><option value=\"Tuesday 05 May, 2026 - 12:00PM\" >Tuesday 05 May, 2026 - 12:00PM<\/option><option value=\"Wednesday 06 May, 2026 - 09:00AM\" >Wednesday 06 May, 2026 - 09:00AM<\/option><option value=\"Wednesday 06 May, 2026 - 10:00AM\" >Wednesday 06 May, 2026 - 10:00AM<\/option><option value=\"Wednesday 06 May, 2026 - 11:00AM\" >Wednesday 06 May, 2026 - 11:00AM<\/option><option value=\"Wednesday 06 May, 2026 - 12:00PM\" >Wednesday 06 May, 2026 - 12:00PM<\/option><option value=\"Thursday 07 May, 2026 - 09:00AM\" >Thursday 07 May, 2026 - 09:00AM<\/option><option value=\"Thursday 07 May, 2026 - 10:00AM\" >Thursday 07 May, 2026 - 10:00AM<\/option><option value=\"Thursday 07 May, 2026 - 11:00AM\" >Thursday 07 May, 2026 - 11:00AM<\/option><option value=\"Thursday 07 May, 2026 - 12:00PM\" >Thursday 07 May, 2026 - 12:00PM<\/option><option value=\"Friday 08 May, 2026 - 09:00AM\" >Friday 08 May, 2026 - 09:00AM<\/option><option value=\"Friday 08 May, 2026 - 10:00AM\" >Friday 08 May, 2026 - 10:00AM<\/option><option value=\"Monday 11 May, 2026 - 09:00AM\" >Monday 11 May, 2026 - 09:00AM<\/option><option value=\"Monday 11 May, 2026 - 10:00AM\" >Monday 11 May, 2026 - 10:00AM<\/option><option value=\"Monday 11 May, 2026 - 11:00AM\" >Monday 11 May, 2026 - 11:00AM<\/option><option value=\"Monday 11 May, 2026 - 12:00PM\" >Monday 11 May, 2026 - 12:00PM<\/option><\/select><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div class=\"wdform_row\" wdid=\"3\"><div type=\"type_radio\" class=\"wdform-field wd-width-100 wd-flex wd-flex-row fm-type_radio\" ><div class=\"wdform-label-section wd-width-30  wd-flex-wrap wd-flex-row\" style=\"max-width: 130px;\">    <label  class=\"wdform-label\">Prefix:<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex  wd-flex-wrap wd-flex-row wd-width-70\" ><div class=\"wd-flex wd-flex-row\"><input type=\"hidden\" name=\"wdform_3_element60\" value=\"\" \/><div class=\"radio-div wd-choice wd-flex wd-flex-row\"><input type=\"radio\"  id=\"wdform_3_element600\" name=\"wdform_3_element60\" value=\"Mr.\" onclick=\"set_default(&quot;wdform_3&quot;,&quot;0&quot;,&quot;60&quot;); \"   ycbm=Prefix \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_3_element600\"><span><\/span>Mr.<\/label><\/div><div class=\"radio-div wd-choice wd-flex wd-flex-row\"><input type=\"radio\"  id=\"wdform_3_element601\" name=\"wdform_3_element60\" value=\"Mrs.\" onclick=\"set_default(&quot;wdform_3&quot;,&quot;1&quot;,&quot;60&quot;); \"   ycbm=Prefix \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_3_element601\"><span><\/span>Mrs.<\/label><\/div><div class=\"radio-div wd-choice wd-flex wd-flex-row\"><input type=\"radio\"  id=\"wdform_3_element602\" name=\"wdform_3_element60\" value=\"Miss\" onclick=\"set_default(&quot;wdform_3&quot;,&quot;2&quot;,&quot;60&quot;); \"   ycbm=Prefix \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_3_element602\"><span><\/span>Miss<\/label><\/div><div class=\"radio-div wd-choice wd-flex wd-flex-row\"><input type=\"radio\"  id=\"wdform_3_element603\" name=\"wdform_3_element60\" value=\"Ms.\" onclick=\"set_default(&quot;wdform_3&quot;,&quot;3&quot;,&quot;60&quot;); \"   ycbm=Prefix \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_3_element603\"><span><\/span>Ms.<\/label><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div class=\"wdform_row\" wdid=\"16\"><div type=\"type_text\" class=\"wdform-field wd-width-100 wd-flex wd-flex-row fm-type_text\" ><div class=\"wdform-label-section wd-width-30  wd-flex-row wd-align-items-center\" style=\"max-width: 130px;\">    <label  for=\"wdform_16_element60\" class=\"wdform-label\">First Name<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex  wd-flex-row wd-align-items-center wd-width-70\" ><input type=\"text\"                           class=\"wd-width-100\"                           id=\"wdform_16_element60\"                           name=\"wdform_16_element60\"                           value=\"\"                           title=\"\"                           placeholder=\"\"                                                       ycbm=FNAME \/><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div class=\"wdform_row\" style=\"position: relative; left: 0px; top: 0px;\" wdid=\"17\"><div type=\"type_text\" class=\"wdform-field wd-width-100 wd-flex wd-flex-row fm-type_text\" ><div class=\"wdform-label-section wd-width-30  wd-flex-row wd-align-items-center\" style=\"max-width: 130px;\">    <label  for=\"wdform_17_element60\" class=\"wdform-label\">Last Name:<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex  wd-flex-row wd-align-items-center wd-width-70\" ><input type=\"text\"                           class=\"wd-width-100\"                           id=\"wdform_17_element60\"                           name=\"wdform_17_element60\"                           value=\"\"                           title=\"\"                           placeholder=\"\"                                                       ycbm=LNAME \/><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div class=\"wdform_row\" wdid=\"5\"><div type=\"type_submitter_mail\" class=\"wdform-field wd-width-100 wd-flex wd-flex-row fm-type_submitter_mail\" ><div class=\"wdform-label-section wd-width-30  wd-flex-row\" style=\"max-width: 130px;\">    <label  for=\"wdform_5_element60\" class=\"wdform-label\">E-mail:<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex  wd-flex-row wd-width-70\" ><input type=\"text\" class=\"wd-width-100\" id=\"wdform_5_element60\" name=\"wdform_5_element60\" value=\"\" title=\"\" placeholder=\"\"   onchange=\"wd_check_email('5', '60', '\u042d\u0442\u043e \u043d\u0435 \u0430\u0434\u0440\u0435\u0441 \u044d\u043b\u0435\u043a\u0442\u0440\u043e\u043d\u043d\u043e\u0439 \u043f\u043e\u0447\u0442\u044b.')\" \/><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div class=\"wdform_row\" wdid=\"6\"><div type=\"type_phone\" class=\"wdform-field wd-width-100 wd-flex wd-flex-row fm-type_phone\" ><div class=\"wdform-label-section wd-width-30  wd-flex-row\" style=\"max-width: 130px;\">    <label  for=\"wdform_6_element_first60\" class=\"wdform-label\">Primary Contact  or Home Phone:<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex  wd-flex-row wd-width-70\" ><div class=\"wd-flex wd-flex-column wd-width-20\">                <input type=\"text\" class=\"wd-phone-first\" id=\"wdform_6_element_first60\" name=\"wdform_6_element_first60\" value=\"\" title=\"\" placeholder=\"\"  ycbm=HPHONE>                <label for=\"wdform_6_element_first60\" class=\"mini_label wd-flex-column\">Area Code<\/label>              <\/div>              <div>                <div class=\"wd-flex wd-flex-column \">&nbsp;-&nbsp;<\/div>              <\/div>              <div class=\"wd-flex wd-flex-column wd-width-80\">                <input type=\"text\" class=\"wd-flex-column wd-width-100\" id=\"wdform_6_element_last60\" name=\"wdform_6_element_last60\" value=\"\" title=\"\" placeholder=\"\"  ycbm=HPHONE \/>                <label for=\"wdform_6_element_last60\" class=\"wd-flex-column mini_label\">Phone Number<\/label>              <\/div><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div class=\"wdform_row\" style=\"position: relative; left: 0px; top: 0px;\" wdid=\"18\"><div type=\"type_phone\" class=\"wdform-field wd-width-100 wd-flex wd-flex-row fm-type_phone\" ><div class=\"wdform-label-section wd-width-30  wd-flex-row\" style=\"max-width: 130px;\">    <label  for=\"wdform_18_element_first60\" class=\"wdform-label\">Mobile Phone:<\/label><\/div><div class=\"wdform-element-section wd-flex  wd-flex-row wd-width-70\" ><div class=\"wd-flex wd-flex-column wd-width-20\">                <input type=\"text\" class=\"wd-phone-first\" id=\"wdform_18_element_first60\" name=\"wdform_18_element_first60\" value=\"\" title=\"\" placeholder=\"\"  ycbm=CPHONE>                <label for=\"wdform_18_element_first60\" class=\"mini_label wd-flex-column\">Area Code<\/label>              <\/div>              <div>                <div class=\"wd-flex wd-flex-column \">&nbsp;-&nbsp;<\/div>              <\/div>              <div class=\"wd-flex wd-flex-column wd-width-80\">                <input type=\"text\" class=\"wd-flex-column wd-width-100\" id=\"wdform_18_element_last60\" name=\"wdform_18_element_last60\" value=\"\" title=\"\" placeholder=\"\"  ycbm=CPHONE \/>                <label for=\"wdform_18_element_last60\" class=\"wd-flex-column mini_label\">Phone Number<\/label>              <\/div><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div wdid=\"48\" class=\"wdform_row\" style=\"position: relative; left: 0px; top: 0px;\"><div type=\"type_editor\" class=\"wdform-field\"><strong>The above phone numbers and email address will be used for communication with your client. Please make sure they are correct, as you will not be able to change them later.<\/strong><\/div><\/div><\/div><div class=\"wdform_column\"><div class=\"wdform_row\" wdid=\"26\"><div type=\"type_text\" class=\"wdform-field wd-width-100 wd-flex wd-flex-row fm-type_text\" ><div class=\"wdform-label-section wd-width-30  wd-flex-row wd-align-items-center\" style=\"max-width: 130px;\">    <label  for=\"wdform_26_element60\" class=\"wdform-label\">Street Address:<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex  wd-flex-row wd-align-items-center wd-width-70\" ><input type=\"text\"                           class=\"wd-width-100\"                           id=\"wdform_26_element60\"                           name=\"wdform_26_element60\"                           value=\"\"                           title=\"\"                           placeholder=\"\"                                                       ycbm=STREETADDRESS \/><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div class=\"wdform_row\" style=\"position: relative; left: 0px; top: 0px;\" wdid=\"27\"><div type=\"type_text\" class=\"wdform-field wd-width-100 wd-flex wd-flex-row fm-type_text\" ><div class=\"wdform-label-section wd-width-30  wd-flex-row wd-align-items-center\" style=\"max-width: 130px;\">    <label  for=\"wdform_27_element60\" class=\"wdform-label\">City:<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex  wd-flex-row wd-align-items-center wd-width-70\" ><input type=\"text\"                           class=\"wd-width-100\"                           id=\"wdform_27_element60\"                           name=\"wdform_27_element60\"                           value=\"\"                           title=\"\"                           placeholder=\"\"                                                       ycbm=CITY \/><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div class=\"wdform_row\" wdid=\"28\"><div type=\"type_text\" class=\"wdform-field wd-width-100 wd-flex wd-flex-row fm-type_text\" ><div class=\"wdform-label-section wd-width-30  wd-flex-row wd-align-items-center\" style=\"max-width: 130px;\">    <label  for=\"wdform_28_element60\" class=\"wdform-label\">Postal Code<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex  wd-flex-row wd-align-items-center wd-width-70\" ><input type=\"text\"                           class=\"wd-width-100\"                           id=\"wdform_28_element60\"                           name=\"wdform_28_element60\"                           value=\"\"                           title=\"\"                           placeholder=\"\"                                                       ycbm=PCODE \/><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div wdid=\"49\" class=\"wdform_row\"><div type=\"type_editor\" class=\"wdform-field\"><strong>The above address will be used for your client\u2019s furniture delivery. Please make sure house number, street, city, and postal code are accurate, as you will not be able to change them later.<\/strong><\/div><\/div><\/div><div class=\"wdform_column\"><div class=\"wdform_row\" style=\"position: relative; left: 0px; top: 0px;\" wdid=\"45\"><div type=\"type_spinner\" class=\"wdform-field wd-width-100 wd-flex wd-flex-row fm-type_spinner\" ><div class=\"wdform-label-section wd-width-30  wd-flex-row\">    <label  for=\"wdform_45_element60\" class=\"wdform-label\">Number of Individuals in the Household:<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex  wd-flex-row wd-width-70\" ><input                            name=\"wdform_45_element60\"                            id=\"wdform_45_element60\"                            class=\"wd-type-number\"                            onkeyup=\"wd_validate(this)\"                            data-valid-type=\"number\"                            data-form-id=\"60\"                            data-wdid=\"45\"                            style=\"width: 60px;\"                            value=\"\"                             ycbm=NOFI \/><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div class=\"wdform_row\" wdid=\"19\"><div type=\"type_checkbox\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_checkbox\" ><div class=\"wdform-label-section wd-width-100 EligibilityReason wd-flex-wrap wd-flex-column\" style=\"max-width: 400px;\">    <label  class=\"wdform-label\">Eligibility Reason (check all that apply)<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex EligibilityReason wd-flex-wrap wd-flex-column wd-width-100\" ><div class=\"wd-flex wd-flex-column\"><input type=\"hidden\" name=\"wdform_19_element60\" value=\"\" \/><div class=\"checkbox-div wd-choice wd-flex wd-flex-row\"><input type=\"checkbox\"  id=\"wdform_19_element600\" name=\"wdform_19_element600\" value=\"Low income\"    ycbm=Eligibility \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_19_element600\"><span><\/span>Low income<\/label><\/div><div class=\"checkbox-div wd-choice wd-flex wd-flex-row\"><input type=\"checkbox\"  id=\"wdform_19_element601\" name=\"wdform_19_element601\" value=\"Moderate income\"    ycbm=Eligibility \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_19_element601\"><span><\/span>Moderate income<\/label><\/div><div class=\"checkbox-div wd-choice wd-flex wd-flex-row\"><input type=\"checkbox\"  id=\"wdform_19_element602\" name=\"wdform_19_element602\" value=\"Currently or recently unemployed\"    ycbm=Eligibility \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_19_element602\"><span><\/span>Currently or recently unemployed<\/label><\/div><div class=\"checkbox-div wd-choice wd-flex wd-flex-row\"><input type=\"checkbox\"  id=\"wdform_19_element603\" name=\"wdform_19_element603\" value=\"New immigrant\"    ycbm=Eligibility \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_19_element603\"><span><\/span>New immigrant<\/label><\/div><div class=\"checkbox-div wd-choice wd-flex wd-flex-row\"><input type=\"checkbox\"  id=\"wdform_19_element604\" name=\"wdform_19_element604\" value=\"Refugee\"    ycbm=Eligibility \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_19_element604\"><span><\/span>Refugee<\/label><\/div><div class=\"checkbox-div wd-choice wd-flex wd-flex-row\"><input type=\"checkbox\"  id=\"wdform_19_element605\" name=\"wdform_19_element605\" value=\"Experienced a natural disaster\"    ycbm=Eligibility \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_19_element605\"><span><\/span>Experienced a natural disaster<\/label><\/div><div class=\"checkbox-div wd-choice wd-flex wd-flex-row\"><input type=\"checkbox\"  id=\"wdform_19_element606\" name=\"wdform_19_element606\" value=\"Unable to obtain employment\"    ycbm=Eligibility \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_19_element606\"><span><\/span>Unable to obtain employment<\/label><\/div><div class=\"checkbox-div wd-choice wd-flex wd-flex-row\"><input type=\"checkbox\"  id=\"wdform_19_element607\" name=\"wdform_19_element607\" value=\"Senior\"    ycbm=Eligibility \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_19_element607\"><span><\/span>Senior<\/label><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div class=\"wdform_row\" wdid=\"43\" style=\"position: relative; left: 0px; top: 0px;\"><div type=\"type_date_new\" class=\"wdform-field wd-width-100 wd-flex wd-flex-row fm-type_date_new\" ><div class=\"wdform-label-section wd-width-30  wd-flex-row\">    <label  for=\"wdform_43_element60\" class=\"wdform-label\">Date of Birth: yyyy-mm-dd<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex  wd-flex-row wd-width-70\" style=\"max-width: 150px;\"><input class=\"wd-width-100\" autocomplete=\"off\" onchange=\"wd_validate(this)\" data-form-id=\"60\" data-wdid=\"43\" data-valid-type=\"date\" type=\"text\" id=\"wdform_43_element60\" value=\"\" name=\"wdform_43_element60\"   ycbm=DateofBirth \/><span id=\"fm-calendar-43\" class=\"dashicons dashicons-calendar-alt wd-calendar-button wd-hidden\"><\/span><input type=\"hidden\" class=\"hidden_date\" data-format=\"yy-mm-dd\" data-min=\"-90y\" data-max=\"-16y\" id=\"wdform_43_button60\" value=\"\" \/><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div wdid=\"51\" class=\"wdform_row\"><div type=\"type_editor\" class=\"wdform-field\"><strong>Please ensure to provide correct month\/day\/year for your client&#039;s Date of Birth<\/strong><\/div><\/div><\/div><div class=\"wdform_column\"><div class=\"wdform_row\" style=\"position: relative; left: 0px; top: 0px;\" wdid=\"32\"><div type=\"type_own_select\" class=\"wdform-field wd-width-100 wd-flex wd-flex-row fm-type_own_select\" ><div class=\"wdform-label-section wd-width-30 wdform_select wd-flex-row\" style=\"max-width: 180px;\">    <label  for=\"wdform_32_element60\" class=\"wdform-label\">Marital Status:<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex wdform_select wd-flex-row wd-width-70\" ><select class=\"wd-width-100\" id=\"wdform_32_element60\" name=\"wdform_32_element60\"  ycbm=MaritalStatus><option value=\"\" selected=\"selected\">Select value<\/option><option value=\"married\" >married<\/option><option value=\"divorced\" >divorced<\/option><option value=\"separated\" >separated<\/option><option value=\"single\" >single<\/option><option value=\"widow(er)\" >widow(er)<\/option><option value=\"common law\" >common law<\/option><option value=\"other\" >other<\/option><\/select><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div class=\"wdform_row\" wdid=\"33\"><div type=\"type_own_select\" class=\"wdform-field wd-width-100 wd-flex wd-flex-row fm-type_own_select\" ><div class=\"wdform-label-section wd-width-30 wdform_select wd-flex-row\" style=\"max-width: 180px;\">    <label  for=\"wdform_33_element60\" class=\"wdform-label\">Household annual Income:<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex wdform_select wd-flex-row wd-width-70\" ><select class=\"wd-width-100\" id=\"wdform_33_element60\" name=\"wdform_33_element60\"  ycbm=income><option value=\"\" selected=\"selected\">Select value<\/option><option value=\"no income\" >no income<\/option><option value=\"$1-$20K\" >$1-$20K<\/option><option value=\"$21K-$30K\" >$21K-$30K<\/option><option value=\"$31K-$40K\" >$31K-$40K<\/option><option value=\"$41K-$50K\" >$41K-$50K<\/option><option value=\"$51K-$60K\" >$51K-$60K<\/option><option value=\"$61K-$70K\" >$61K-$70K<\/option><option value=\"more than $70K\" >more than $70K<\/option><\/select><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div class=\"wdform_row\" wdid=\"47\"><div type=\"type_spinner\" class=\"wdform-field wd-width-100 wd-flex wd-flex-row fm-type_spinner\" ><div class=\"wdform-label-section wd-width-30  wd-flex-row\">    <label  for=\"wdform_47_element60\" class=\"wdform-label\">Number of Children in the Household:<\/label><\/div><div class=\"wdform-element-section wd-flex  wd-flex-row wd-width-70\" ><input                            name=\"wdform_47_element60\"                            id=\"wdform_47_element60\"                            class=\"wd-type-number\"                            onkeyup=\"wd_validate(this)\"                            data-valid-type=\"number\"                            data-form-id=\"60\"                            data-wdid=\"47\"                            style=\"width: 60px;\"                            value=\"\"                             ycbm=NumberofChildren \/><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div class=\"wdform_row\" wdid=\"46\"><div type=\"type_spinner\" class=\"wdform-field wd-width-100 wd-flex wd-flex-row fm-type_spinner\" ><div class=\"wdform-label-section wd-width-30  wd-flex-row\">    <label  for=\"wdform_46_element60\" class=\"wdform-label\">Number of Bedrooms:<\/label><\/div><div class=\"wdform-element-section wd-flex  wd-flex-row wd-width-70\" ><input                            name=\"wdform_46_element60\"                            id=\"wdform_46_element60\"                            class=\"wd-type-number\"                            onkeyup=\"wd_validate(this)\"                            data-valid-type=\"number\"                            data-form-id=\"60\"                            data-wdid=\"46\"                            style=\"width: 60px;\"                            value=\"\"                             ycbm=NumberofBedrooms \/><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div class=\"wdform_row\" wdid=\"36\"><div type=\"type_own_select\" class=\"wdform-field wd-width-100 wd-flex wd-flex-row fm-type_own_select\" ><div class=\"wdform-label-section wd-width-30 wdform_select wd-flex-row\" style=\"max-width: 200px;\">    <label  for=\"wdform_36_element60\" class=\"wdform-label\">Housing Status :<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex wdform_select wd-flex-row wd-width-70\" ><select class=\"wd-width-100\" id=\"wdform_36_element60\" name=\"wdform_36_element60\"  ycbm=HousingStatus><option value=\"\" selected=\"selected\">Select value<\/option><option value=\"client owned\" >client owned<\/option><option value=\"market rent\" >market rent<\/option><option value=\"subsidized\" >subsidized<\/option><option value=\"other\" >other<\/option><\/select><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div class=\"wdform_row\" wdid=\"37\"><div type=\"type_own_select\" class=\"wdform-field wd-width-100 wd-flex wd-flex-row fm-type_own_select\" ><div class=\"wdform-label-section wd-width-30 wdform_select wd-flex-row\" style=\"max-width: 200px;\">    <label  for=\"wdform_37_element60\" class=\"wdform-label\">Type of Housing:<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex wdform_select wd-flex-row wd-width-70\" ><select class=\"wd-width-100\" id=\"wdform_37_element60\" name=\"wdform_37_element60\"  ycbm=TypeofHousing><option value=\"\" selected=\"selected\">Select value<\/option><option value=\"Basement\" >Basement<\/option><option value=\"Detached house\" >Detached house<\/option><option value=\"Townhouse\" >Townhouse<\/option><option value=\"Apartment with elevator\" >Apartment with elevator<\/option><option value=\"Apartment with no elevator\" >Apartment with no elevator<\/option><option value=\"Ground Floor\" >Ground Floor<\/option><\/select><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div wdid=\"50\" class=\"wdform_row\"><div type=\"type_editor\" class=\"wdform-field\"><strong>This information will be used by JRCC movers for furniture delivery.  Please ensure to indicate the correct type of residence, as it cannot be changed later.<\/strong><\/div><\/div><\/div><div class=\"wdform_column\"><div class=\"wdform_row\" wdid=\"38\"><div type=\"type_checkbox\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_checkbox\" ><div class=\"wdform-label-section wd-width-100 LanguageSpoken wd-flex-wrap wd-flex-column\" style=\"max-width: 290px;\">    <label  class=\"wdform-label\">Language Spoken (check all that apply):<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex LanguageSpoken wd-flex-wrap wd-flex-column wd-width-100\" ><div class=\"wd-flex wd-flex-column\"><input type=\"hidden\" name=\"wdform_38_element60\" value=\"\" \/><div class=\"checkbox-div wd-choice wd-flex wd-flex-row\"><input type=\"checkbox\"  id=\"wdform_38_element600\" name=\"wdform_38_element600\" value=\"English\"    ycbm=LanguageSpoken \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_38_element600\"><span><\/span>English<\/label><\/div><div class=\"checkbox-div wd-choice wd-flex wd-flex-row\"><input type=\"checkbox\"  id=\"wdform_38_element601\" name=\"wdform_38_element601\" value=\"Russian\"    ycbm=LanguageSpoken \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_38_element601\"><span><\/span>Russian<\/label><\/div><div class=\"checkbox-div wd-choice wd-flex wd-flex-row\"><input type=\"checkbox\"  id=\"wdform_38_element602\" name=\"wdform_38_element602\" value=\"Hebrew\"    ycbm=LanguageSpoken \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_38_element602\"><span><\/span>Hebrew<\/label><\/div><div class=\"checkbox-div wd-choice wd-flex wd-flex-row\"><input type=\"checkbox\"  id=\"wdform_38_element603\" name=\"wdform_38_element603\" value=\"French\"    ycbm=LanguageSpoken \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_38_element603\"><span><\/span>French<\/label><\/div><div class=\"checkbox-div wd-choice wd-flex wd-flex-row\"><input type=\"checkbox\"  id=\"wdform_38_element604\" name=\"wdform_38_element604\" value=\"Spanish\"    ycbm=LanguageSpoken \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_38_element604\"><span><\/span>Spanish<\/label><\/div><div class=\"checkbox-div wd-choice wd-flex wd-flex-row\"><input type=\"checkbox\"  id=\"wdform_38_element605\" name=\"wdform_38_element605\" value=\"Arabic\"    ycbm=LanguageSpoken \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_38_element605\"><span><\/span>Arabic<\/label><\/div><div class=\"checkbox-div wd-choice wd-flex wd-flex-row\"><input type=\"checkbox\"  id=\"wdform_38_element606\" name=\"wdform_38_element606\" value=\"Other\"    ycbm=LanguageSpoken \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_38_element606\"><span><\/span>Other<\/label><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div class=\"wdform_row\" wdid=\"39\"><div type=\"type_radio\" class=\"wdform-field wd-width-100 wd-flex wd-flex-row fm-type_radio\" ><div class=\"wdform-label-section wd-width-30  wd-flex-wrap wd-flex-row\" style=\"max-width: 100px;\">    <label  class=\"wdform-label\">Immigrant:<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex  wd-flex-wrap wd-flex-row wd-width-70\" ><div class=\"wd-flex wd-flex-row\"><input type=\"hidden\" name=\"wdform_39_element60\" value=\"\" \/><div class=\"radio-div wd-choice wd-flex wd-flex-row\"><input type=\"radio\"  id=\"wdform_39_element600\" name=\"wdform_39_element60\" value=\"yes\" onclick=\"set_default(&quot;wdform_39&quot;,&quot;0&quot;,&quot;60&quot;); \"   ycbm=Immigrant \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_39_element600\"><span><\/span>yes<\/label><\/div><div class=\"radio-div wd-choice wd-flex wd-flex-row\"><input type=\"radio\"  id=\"wdform_39_element601\" name=\"wdform_39_element60\" value=\"no\" onclick=\"set_default(&quot;wdform_39&quot;,&quot;1&quot;,&quot;60&quot;); \"   ycbm=Immigrant \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_39_element601\"><span><\/span>no<\/label><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div class=\"wdform_row\" style=\"position: relative; left: 0px; top: 0px;\" wdid=\"44\"><div type=\"type_date_new\" class=\"wdform-field wd-width-100 wd-flex wd-flex-row fm-type_date_new\" ><div class=\"wdform-label-section wd-width-30  wd-flex-row\">    <label  for=\"wdform_44_element60\" class=\"wdform-label\">Immigration Date:<\/label><\/div><div class=\"wdform-element-section wd-flex  wd-flex-row wd-width-70\" ><input class=\"wd-width-100\" autocomplete=\"off\" onchange=\"wd_validate(this)\" data-form-id=\"60\" data-wdid=\"44\" data-valid-type=\"date\" type=\"text\" id=\"wdform_44_element60\" value=\"\" name=\"wdform_44_element60\"   ycbm=ImmigrationDate \/><span id=\"fm-calendar-44\" class=\"dashicons dashicons-calendar-alt wd-calendar-button wd-hidden\"><\/span><input type=\"hidden\" class=\"hidden_date\" data-format=\"mm\/dd\/yy\" data-min=\"01\/01\/1920\" data-max=\"today\" id=\"wdform_44_button60\" value=\"\" \/><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div class=\"wdform_row\" style=\"position: relative; left: 0px; top: 0px;\" wdid=\"41\"><div type=\"type_own_select\" class=\"wdform-field wd-width-100 wd-flex wd-flex-row fm-type_own_select\" ><div class=\"wdform-label-section wd-width-30 wdform_select wd-flex-row\" style=\"max-width: 180px;\">    <label  for=\"wdform_41_element60\" class=\"wdform-label\">Need Furniture Because:<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex wdform_select wd-flex-row wd-width-70\" ><select class=\"wd-width-100\" id=\"wdform_41_element60\" name=\"wdform_41_element60\"  ycbm=NeedFurnitureBecause><option value=\"\" selected=\"selected\">Select value<\/option><option value=\"Have no furniture\" >Have no furniture<\/option><option value=\"Have some furniture, but need mattress and\/or table and\/or chairs\" >Have some furniture, but need mattress and\/or table and\/or chairs<\/option><option value=\"Have furniture, but need more\" >Have furniture, but need more<\/option><option value=\"Have furniture but need to replace it\" >Have furniture but need to replace it<\/option><option value=\"Have furniture, but want better ones\" >Have furniture, but want better ones<\/option><\/select><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div class=\"wdform_row\" wdid=\"42\"><div type=\"type_own_select\" class=\"wdform-field wd-width-100 wd-flex wd-flex-row fm-type_own_select\" ><div class=\"wdform-label-section wd-width-30 wdform_select wd-flex-row\" style=\"max-width: 200px;\">    <label  for=\"wdform_42_element60\" class=\"wdform-label\">Backend Instance:<\/label><\/div><div class=\"wdform-element-section wd-flex wdform_select wd-flex-row wd-width-70\" ><select class=\"wd-width-100\" id=\"wdform_42_element60\" name=\"wdform_42_element60\" ><option value=\"Production\" selected=\"selected\">Production<\/option><option value=\"Test\" >Test<\/option><\/select><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div class=\"wdform_row\" wdid=\"14\"><div type=\"type_submit_reset\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_submit_reset\" ><div class=\"wdform-element-section wd-flex  wd-flex-row wd-justify-content-left wd-width-100\" ><button  type=\"button\" class=\"button-submit\" onclick=\"fm_submit_form('60');\"  data-ajax=\"0\"><span class=\"fm-submit-loading spinner fm-ico-spinner\"><\/span>Submit<\/button><button  type=\"button\" class=\"button-reset \" onclick=\"fm_reset_form(60);\" >Reset<\/button><\/div><\/div><\/div><\/div><\/div><div class=\"wdform_footer\" style=\"width: 100%;\" valign=\"top\"><div style=\"width: 100%;\"><div style=\"width: 100%; padding-top: 10px; display: table;\"><div style=\"display: table-row-group;\"><div id=\"60page_nav1\" style=\"display: table-row;\"><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"wdform_preload\"><\/div><input type=\"hidden\" name=\"fm-current-page\" value=\"https:\/\/www.jrccfurnituredepot.org\/ru\/wp-json\/wp\/v2\/pages\/493\" \/><\/form><\/div>\n","protected":false},"excerpt":{"rendered":"<p>* From time to time we experience high demand, and our client calendar may be fully booked. If there are no available dates on the calendar, kindly check for availability again the following morning. Thank you for your cooperation and support.<\/p>\n","protected":false},"author":84,"featured_media":0,"parent":83,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"jrcc_agency_form_template.php","meta":{"spay_email":"","footnotes":""},"translation":{"provider":"WPGlobus","version":"2.6.5","language":"ru","enabled_languages":["en","ru","he"],"languages":{"en":{"title":true,"content":true,"excerpt":false},"ru":{"title":false,"content":false,"excerpt":false},"he":{"title":false,"content":false,"excerpt":false}}},"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/P782dC-7X","_links":{"self":[{"href":"https:\/\/www.jrccfurnituredepot.org\/ru\/wp-json\/wp\/v2\/pages\/493"}],"collection":[{"href":"https:\/\/www.jrccfurnituredepot.org\/ru\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.jrccfurnituredepot.org\/ru\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.jrccfurnituredepot.org\/ru\/wp-json\/wp\/v2\/users\/84"}],"replies":[{"embeddable":true,"href":"https:\/\/www.jrccfurnituredepot.org\/ru\/wp-json\/wp\/v2\/comments?post=493"}],"version-history":[{"count":30,"href":"https:\/\/www.jrccfurnituredepot.org\/ru\/wp-json\/wp\/v2\/pages\/493\/revisions"}],"predecessor-version":[{"id":3125,"href":"https:\/\/www.jrccfurnituredepot.org\/ru\/wp-json\/wp\/v2\/pages\/493\/revisions\/3125"}],"up":[{"embeddable":true,"href":"https:\/\/www.jrccfurnituredepot.org\/ru\/wp-json\/wp\/v2\/pages\/83"}],"wp:attachment":[{"href":"https:\/\/www.jrccfurnituredepot.org\/ru\/wp-json\/wp\/v2\/media?parent=493"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}