{"id":549,"date":"2025-08-18T23:20:48","date_gmt":"2025-08-18T23:20:48","guid":{"rendered":"https:\/\/justpenny.org\/?page_id=549"},"modified":"2025-08-19T21:12:51","modified_gmt":"2025-08-19T21:12:51","slug":"emergency-food-support","status":"publish","type":"page","link":"https:\/\/justpenny.org\/index.php\/emergency-food-support\/","title":{"rendered":"Emergency Food Support"},"content":{"rendered":"<div  data-label=\"Contact\" data-id=\"contact--1\" data-export-id=\"contact-1\" data-category=\"contact\" class=\"contact-1 content-section content-section-spacing section-title-col-dark-text\" data-parallax-depth=\"20\" id=\"contact-1\" style=\"background-color: rgb(255, 255, 255); background-image: url(&quot;https:\/\/justpenny.org\/wp-content\/uploads\/2025\/08\/20250817_1438_Volunteer-Event-Logo_remix_01k2w3yz2ce9gs8s53sskb9djd.png&quot;); background-size: cover; background-position: center top;\" data-section-ov=\"1\"><div  class=\"gridContainer\"> <div  class=\"row 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var(--gf-field-img-choice-check-ind-size-md);--gf-field-img-choice-check-ind-icon-size: var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style><div id='gf_9' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Emergency Food Support<\/h2>\n                            <p class='gform_description'>You can use this form to apply for instant help. We usually provide either dry groceries or supermarket vouchers, which you can use to collect food.\r\n\r\nIf this is your first time applying, please complete the form below. After your initial support, you may contact to a reputable agency like Trussell Trust, Turn2Us etc. Based on their recommendation, we may be able to provide you with further supplies of groceries or vouchers after this supply.\r\n\r\nPlease take few moments to fill in the form below.<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_9' class='jp-orange-form' action='\/index.php\/wp-json\/wp\/v2\/pages\/549#gf_9' data-formid='9' novalidate>\n        <div id='gf_progressbar_wrapper_9' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>2<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_50' style='width:50%;'><span>50%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_9_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_9' class='gform_fields top_label form_sublabel_above description_below validation_below'><div id=\"field_9_7\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About You<\/h3><\/div><div id=\"field_9_41\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_41'>Title<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_41' id='input_9_41' class='small gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Please Choose One' selected='selected'>Please Choose One<\/option><option value='Mr' >Mr<\/option><option value='Miss' >Miss<\/option><option value='Mrs' >Mrs<\/option><option value='Ms' >Ms<\/option><\/select><\/div><\/div><fieldset id=\"field_9_1\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Your Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_9_1'>\n                            \n                            <span id='input_9_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_9_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_1.3' id='input_9_1_3' value=''   aria-required='true'    autocomplete=\"given-name\" \/>\n                                                <\/span>\n                            \n                            <span id='input_9_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_9_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_1.6' id='input_9_1_6' value=''   aria-required='true'    autocomplete=\"family-name\" \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_9_18\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_18'>House \/ Flat Number \/  Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_18' id='input_9_18' type='text' value='' class='small'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_4\" class=\"gfield gfield--type-address gfield--input-type-address field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Your Address<\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_country ginput_container_address gform-grid-row' id='input_9_4' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_9_4_1_container' >\n                                        <label for='input_9_4_1' id='input_9_4_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_4.1' id='input_9_4_1' value=''    aria-required='false'   autocomplete=\"address-line1\" \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_9_4_2_container' >\n                                        <label for='input_9_4_2' id='input_9_4_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                        <input type='text' name='input_4.2' id='input_9_4_2' value=''    autocomplete=\"address-line2\" aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_9_4_3_container' >\n                                    <label for='input_9_4_3' id='input_9_4_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_4.3' id='input_9_4_3' value=''    aria-required='false'   autocomplete=\"address-level2\" \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_4.4' id='input_9_4_4' value='Virginia'\/><input type='hidden' class='gform_hidden' name='input_4.6' id='input_9_4_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_9_19\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_19'>Post \/ Zip Code<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_9_19' type='text' value='' class='small'    placeholder='SW1A 1AA' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_14\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is this your first time applying for support from us?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_14'>\n\t\t\t<div class='gchoice gchoice_9_14_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='Yes'  id='choice_9_14_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_14_0' id='label_9_14_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_14_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='No'  id='choice_9_14_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_14_1' id='label_9_14_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_37\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_37'>If First Time then your utility Bill will be required. Please upload<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='12582912' \/><input name='input_37' id='input_9_37' type='file' class='large' aria-describedby=\"gfield_upload_rules_9_37 gfield_description_9_37\" onchange='javascript:gformValidateFileSize( this, 12582912 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_9_37'>Accepted file types: pdf, jpg, jpeg, png, webp, gif, docx, Max. file size: 12 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_9_37'><\/div> <\/div><div class='gfield_description' id='gfield_description_9_37'>Only one time required to verify your address. Utility bill , Council Tax , Scheduled Bank letter, Family credit letter etc only accepted.<\/div><\/div><fieldset id=\"field_9_24\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >If not first time then do you have referral Letter ?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_24'>\n\t\t\t<div class='gchoice gchoice_9_24_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='You will have to attach referral letter'  id='choice_9_24_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_9_24\"   \/>\n\t\t\t\t\t<label for='choice_9_24_0' id='label_9_24_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_24_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='Second time with no referral will not proceed further.'  id='choice_9_24_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_24_1' id='label_9_24_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_9_24'>Do you have a current referral\/recommendation from a recognised agency (Citizens Advice, Council, Trussell Trust, GP, School)?<\/div><\/fieldset><div id=\"field_9_25\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_25'>Please upload your Referral letter here<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='12582912' \/><input name='input_25' id='input_9_25' type='file' class='large' aria-describedby=\"gfield_upload_rules_9_25 gfield_description_9_25\" onchange='javascript:gformValidateFileSize( this, 12582912 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_9_25'>Accepted file types: pdf, jpg, jpeg, png, webp, gif, docx, Max. file size: 12 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_9_25'><\/div> <\/div><div class='gfield_description' id='gfield_description_9_25'>Required for those who are applying second time . <\/div><\/div><div id=\"field_9_10\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">How Can We Reach You?<\/h3><div class='gsection_description' id='gfield_description_9_10'>We would love to chat with you. How can we get in touch?<\/div><\/div><div id=\"field_9_11\" class=\"gfield gfield--type-select gfield--input-type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_11'>Preferred Method of Contact<\/label><div class='ginput_container ginput_container_select'><select name='input_11' id='input_9_11' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Email' >Email<\/option><option value='Phone' >Phone<\/option><\/select><\/div><\/div><fieldset id=\"field_9_2\" class=\"gfield gfield--type-email gfield--input-type-email gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Your Email Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_9_2_container'>\n                                <span id='input_9_2_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <label for='input_9_2' class='gform-field-label gform-field-label--type-sub '>Email Address<\/label>\n                                    <input class='' type='email' name='input_2' id='input_9_2' value=''    aria-required=\"true\" aria-invalid=\"false\"  autocomplete=\"email\"\/>\n                                <\/span>\n                                <span id='input_9_2_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <label for='input_9_2_2' class='gform-field-label gform-field-label--type-sub '>Confirm Email Address<\/label>\n                                    <input class='' type='email' name='input_2_2' id='input_9_2_2' value=''    aria-required=\"true\" aria-invalid=\"false\"  autocomplete=\"email\"\/>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><div id=\"field_9_5\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_5'>Your Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_5' id='input_9_5' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"  autocomplete=\"tel\" \/><\/div><\/div><div id=\"field_9_12\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_12'>Best Time to Call You<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_12' id='input_9_12' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected'>Select A Time<\/option><option value='12:00 am' >12:00 am<\/option><option value='12:30 am' >12:30 am<\/option><option value='1:00 am' >1:00 am<\/option><option value='1:30 am' >1:30 am<\/option><option value='2:00 am' >2:00 am<\/option><option value='2:30 am' >2:30 am<\/option><option value='3:00 am' >3:00 am<\/option><option value='3:30 am' >3:30 am<\/option><option value='4:00 am' >4:00 am<\/option><option value='4:30 am' >4:30 am<\/option><option value='5:00 am' >5:00 am<\/option><option value='5:30 am' >5:30 am<\/option><option value='6:00 am' >6:00 am<\/option><option value='6:30 am' >6:30 am<\/option><option value='7:00 am' >7:00 am<\/option><option value='7:30 am' >7:30 am<\/option><option value='8:00 am' >8:00 am<\/option><option value='8:30 am' >8:30 am<\/option><option value='9:00 am' >9:00 am<\/option><option value='9:30 am' >9:30 am<\/option><option value='10:00 am' >10:00 am<\/option><option value='10:30 am' >10:30 am<\/option><option value='11:00 am' >11:00 am<\/option><option value='11:30 am' >11:30 am<\/option><option value='12:00 pm' >12:00 pm<\/option><option value='12:30 pm' >12:30 pm<\/option><option value='1:00 pm' >1:00 pm<\/option><option value='1:30 pm' >1:30 pm<\/option><option value='2:00 pm' >2:00 pm<\/option><option value='2:30 pm' >2:30 pm<\/option><option value='3:00 pm' >3:00 pm<\/option><option value='3:30 pm' >3:30 pm<\/option><option value='4:00 pm' >4:00 pm<\/option><option value='4:30 pm' >4:30 pm<\/option><option value='5:00 pm' >5:00 pm<\/option><option value='5:30 pm' >5:30 pm<\/option><option value='6:00 pm' >6:00 pm<\/option><option value='6:30 pm' >6:30 pm<\/option><option value='7:00 pm' >7:00 pm<\/option><option value='7:30 pm' >7:30 pm<\/option><option value='8:00 pm' >8:00 pm<\/option><option value='8:30 pm' >8:30 pm<\/option><option value='9:00 pm' >9:00 pm<\/option><option value='9:30 pm' >9:30 pm<\/option><option value='10:00 pm' >10:00 pm<\/option><option value='10:30 pm' >10:30 pm<\/option><option value='11:00 pm' >11:00 pm<\/option><option value='11:30 pm' >11:30 pm<\/option><\/select><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_9_13' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_2' class='gform_page' data-js='page-field-id-13' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_2' class='gform_fields top_label form_sublabel_above description_below validation_below'><div id=\"field_9_34\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_34'>PLEASE DISCONTINUE FILLING THIS FORM AND COME BACK WITH REFERRAL FROM AGENCIES ABOVE .WITHOUT REFERRAL WE DO NOT EXTEND SECOND TIME HELP.<\/label><div class='ginput_container ginput_container_text'><input name='input_34' id='input_9_34' type='text' value='' class='medium'  aria-describedby=\"gfield_description_9_34\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_9_34'>You may insert your remarks why should we help you without referral second time?<\/div><\/div><div id=\"field_9_15\" class=\"gfield gfield--type-number gfield--input-type-number gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_15'>Number of Adults in Household<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_15' id='input_9_15' type='number' step='any' min='0' max='9' value='' class='small'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_9_15\" \/><div class='gfield_description instruction ' id='gfield_instruction_9_15'>Please enter a number from <strong>0<\/strong> to <strong>9<\/strong>.<\/div><\/div><\/div><div id=\"field_9_16\" class=\"gfield gfield--type-number gfield--input-type-number Number of Children (Under 18) gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_16'>Number of Children (Under 18)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_16' id='input_9_16' type='number' step='any' min='0' max='9' value='' class='small'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_9_16\" \/><div class='gfield_description instruction ' id='gfield_instruction_9_16'>Please enter a number from <strong>0<\/strong> to <strong>9<\/strong>.<\/div><\/div><\/div><div id=\"field_9_17\" class=\"gfield gfield--type-number gfield--input-type-number gfield_contains_required gfield_calculation field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_17'>Total Household Members<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_17' id='input_9_17' type='text' step='any'   value='' class='small gform-text-input-reset'  readonly=\"readonly\"   aria-required=\"true\" aria-invalid=\"false\"  \/ readonly=\"readonly\" aria-readonly=\"true\"><\/div><\/div><fieldset id=\"field_9_20\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Consent<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_20.1' id='input_9_20_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_9_20_1' >I agree to the Terms and Privacy Policy of JustPenny CIC. I understand that if I give false information or make a false claim for emergency help, I may be held responsible and could face legal action.<\/label><input type='hidden' name='input_20.2' value='I agree to the Terms and Privacy Policy of JustPenny CIC. I understand that if I give false information or make a false claim for emergency help, I may be held responsible and could face legal action.' class='gform_hidden' \/><input type='hidden' name='input_20.3' value='5' class='gform_hidden' \/><\/div><\/fieldset><div id=\"field_9_22\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_22'>Print Full Name (Elelectronic Signatures)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_9_22' type='text' value='' class='medium'  aria-describedby=\"gfield_description_9_22\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_9_22'>By typing my full name above, I agree this will serve as my electronic signature and has the same legal effect as a handwritten signature.<\/div><\/div><div id=\"field_9_28\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_9_28'>Repeat Flag<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_28' id='input_9_28' type='text' value='Repeat' class='small'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_30\" class=\"gfield gfield--type-number gfield--input-type-number field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_9_30'>Voucher \u00a320 (1\u20132 people)<\/label><div class='ginput_container ginput_container_number'><input name='input_30' id='input_9_30' type='number' step='any'   value='20' class='small'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_9_31\" class=\"gfield gfield--type-number gfield--input-type-number field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_9_31'>Voucher \u00a340 (3\u20134 people)<\/label><div class='ginput_container ginput_container_number'><input name='input_31' id='input_9_31' type='number' step='any'   value='40' class='small'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_9_32\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_9_32'>Voucher \u00a360 (5+ people)<\/label><div class='ginput_container ginput_container_number'><input name='input_32' id='input_9_32' type='number' step='any'   value='60' class='small'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_9_33\" class=\"gfield gfield--type-number gfield--input-type-number gfield_calculation field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_33'>Your likely entitlement of Voucher Amount is (\u00a3) :<\/label><div class='ginput_container ginput_container_number'><input name='input_33' id='input_9_33' type='text' step='any'   value='' class='large gform-text-input-reset'  readonly=\"readonly\"    aria-invalid=\"false\" aria-describedby=\"gfield_description_9_33\" \/ readonly=\"readonly\" aria-readonly=\"true\"><\/div><div class='gfield_description' id='gfield_description_9_33'>This is not guaranteed but we try our best to help with above amount .<\/div><\/div><div id=\"field_9_40\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_40'>Choose  Your Password<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_40' id='input_9_40' type='password' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><input type='submit' id='gform_previous_button_9' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='submit' id='gform_submit_button_9' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Submit'  \/> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_9' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_9' id='gform_theme_9' value='orbital' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_9' id='gform_style_settings_9' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_9' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='9' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_9' 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