<?xml version="1.0" encoding="UTF-8"?><rss version="2.0"
	xmlns:content="http://purl.org/rss/1.0/modules/content/"
	xmlns:wfw="http://wellformedweb.org/CommentAPI/"
	xmlns:dc="http://purl.org/dc/elements/1.1/"
	xmlns:atom="http://www.w3.org/2005/Atom"
	xmlns:sy="http://purl.org/rss/1.0/modules/syndication/"
	xmlns:slash="http://purl.org/rss/1.0/modules/slash/"
	>

<channel>
	<title>Speaker&#039;s team Archives - Charlie Morecraft</title>
	<atom:link href="https://www.charlieonsafety.com/tag/speakers-team/feed/" rel="self" type="application/rss+xml" />
	<link>https://www.charlieonsafety.com/tag/speakers-team/</link>
	<description>Safety Motivational Speaker</description>
	<lastBuildDate>Mon, 13 Feb 2023 23:36:00 +0000</lastBuildDate>
	<language>en-US</language>
	<sy:updatePeriod>
	hourly	</sy:updatePeriod>
	<sy:updateFrequency>
	1	</sy:updateFrequency>
	<generator>https://wordpress.org/?v=6.9</generator>
	<item>
		<title>Safety Presentations with Motivational Safety Speaker Scott Burrows</title>
		<link>https://www.charlieonsafety.com/safety-presentations-with-motivational-safety-speaker-scott-burrows/</link>
		
		<dc:creator><![CDATA[Charlie Morecraft]]></dc:creator>
		<pubDate>Thu, 22 Sep 2022 17:16:02 +0000</pubDate>
				<category><![CDATA[Latest News]]></category>
		<category><![CDATA[safety coach]]></category>
		<category><![CDATA[Speaker's Team]]></category>
		<category><![CDATA[Change Management Speaker]]></category>
		<category><![CDATA[Educational Speaker]]></category>
		<category><![CDATA[Fleet Safety]]></category>
		<category><![CDATA[Healthcare Speaker]]></category>
		<category><![CDATA[Insurance and Financial Speaker]]></category>
		<category><![CDATA[Keynote Safety Speakers]]></category>
		<category><![CDATA[Overcoming Adversity Speaker]]></category>
		<category><![CDATA[Pharmaceutical Speaker]]></category>
		<category><![CDATA[Resilience Speaker]]></category>
		<category><![CDATA[Safety Speaker]]></category>
		<category><![CDATA[Safety Teams]]></category>
		<category><![CDATA[Scott Burrows]]></category>
		<category><![CDATA[Speaker's team]]></category>
		<guid isPermaLink="false">https://www.charlieonsafety.com/?p=2615</guid>

					<description><![CDATA[<p>We are proud to have Scott Burrows, Motivational Safety Speaker, as part of our speaker’s team! Scott Burrows Biography Scott Burrows is a motivational safety speaker who brings the concepts of Vision, Mindset and Grit to life using his life-changing story as the backdrop for organizational success. Three simple, yet powerful words that when put &#8230; </p>
<p>The post <a href="https://www.charlieonsafety.com/safety-presentations-with-motivational-safety-speaker-scott-burrows/">Safety Presentations with Motivational Safety Speaker Scott Burrows</a> appeared first on <a href="https://www.charlieonsafety.com">Charlie Morecraft</a>.</p>
]]></description>
										<content:encoded><![CDATA[<h4>We are proud to have Scott Burrows, Motivational Safety Speaker, as part of our speaker’s team!</h4>
<p class="fv-flowplayer-feed"><a href="https://www.charlieonsafety.com/safety-presentations-with-motivational-safety-speaker-scott-burrows/" title="Click to watch the video">[This post contains video, click to play]<br /><img decoding="async" src="https://www.charlieonsafety.com/wp-content/uploads/2022/09/scott-presentation-video-splash.jpg" width="400" /></a></p>
<h3>Scott Burrows Biography</h3>
<p>Scott Burrows is a motivational safety speaker who brings the concepts of Vision, Mindset and Grit to life using his life-changing story as the backdrop for organizational success. Three simple, yet powerful words that when put into action can help your organization stand up to any challenge.</p>
<p>By the age of 19, Scott played college football at Florida State University for legendary coach Bobby Bowden and was a top-ranked kick-boxing Black Belt champion whose last fight was broadcast by ESPN. Scott&#8217;s life changed dramatically when he survived a catastrophic car accident that left him paralyzed from the chest down and diagnosed a quadriplegic. Told he would be confined to a wheelchair for the rest of his life, Scott realized his split-second decision to not wear a seat belt had altered his course forever.</p>
<p>Despite his grim diagnosis, Scott astounded his doctors and refused to be sidelined. After graduating with a degree in Finance, Scott served as a Financial Advisor. At the pinnacle of his career, Scott experienced yet another setback, a second automobile accident. Although buckled in this time, new injuries forced him to RE-evaluate, RE-invent and once again RE-ignite his life by practicing what he preaches.</p>
<p>During his nine month recovery, Scott reminisced about the overcoming adversity speakers he heard at sales and leadership conferences. Their life-changing stories inspire others to chase their dreams, regardless of obstacles or barriers. That’s when Scott decided he would make the tough decision to leave an industry he had so much passion and success in to pursue a speaking career that has taken him around the world.</p>
<p><strong>SAFETY PRESENTATIONS:</strong></p>
<h1><strong>#1 &#8211; Develop an Unstoppable Mindset: Success Strategies for Safety Teams &amp; Supervisors</strong></h1>
<p>With the alarming predominance of workplace accidents caused by human error, the importance of engaging teams and individuals with safety procedures in a way that is meaningful to them and can promote significant change is crucial. Scott details his unforgettable, life-changing story of turning a paralyzing setback into a powerful comeback that inspires teams to develop a true safety <strong>MINDSET</strong>. Scott details how easy it is to become desensitized to common safety routines, and how &#8216;just this once&#8217; can tragically impact the rest of their lives.</p>
<p>Told while using his own physical paralysis as a metaphor and blending eloquent storytelling with humor and crowd interaction, Scott leaves audiences captivated, inspired and ready to take action. Scott will impact your team by encouraging awareness, better day-to-day safety decisions and changing the way your employees view and approach their jobs. Listeners will walk away embracing workplace safety protocols as opposed to resisting or ignoring them.</p>
<ul>
<li>Examine the safety Mindset of <strong><em>poise, execution and non-resistance</em></strong></li>
<li>Learn how to create a clear Vision that entices your employees to <strong><em>follow safety procedures and</em></strong> <strong><em>promotes accountability for their teammates</em></strong></li>
<li>Understand how forgiveness, a leadership trait, <strong><em>increases employee engagement and leads to greater safety protocol adherence</em></strong></li>
<li>Find out how <strong><em>asking the ‘what’ questions </em></strong>can get you thinking differently and help prevent accidents in the workplace</li>
<li>Discover how to not let your mindset become your biggest handicap to <strong><em>increase productivity</em></strong></li>
<li>Cultivate ways to unlock your Grit that can <strong><em>improve safety performance</em></strong></li>
</ul>
<h1><strong> #2 &#8211; </strong><strong>The Mindset of Safety for Supervisors</strong></h1>
<p>Frontline safety supervisors are the linchpin for an effective safety culture and responsible for creating an environment that embraces self-awareness, accountability and non-resistance. In the midst of analyzing hazard investigations, regulatory requirements, training and maintaining a safe work environment, it is easy to lose focus, and harder still to find the daily grit to persevere in an ever-changing environment.</p>
<p>In this impactful leadership safety presentation, Scott teaches supervisors how to inspire teams to make better safety decisions while staying focused on a shared company vision that will lower your recordables.</p>
<ul>
<li>What can I do to lead by example that will demonstrate my investment in individual team members and help educate workers that even a minor accident can have a devastating effect on everyone?</li>
<li>What can I do to encourage a shared responsibility in team members to not only follow individual procedures, but to ensure teammates are also demonstrating safe behaviors in the workplace?</li>
<li>What can I do today to positively reinforce safety compliance through encouragement and reward, rather than merely negative consequences after an accident has occurred?</li>
<li>What can I do to encourage my co-workers to make better safety decisions that will safeguard company protocols so they are not overlooked by management and fellow workers?</li>
</ul>
<h1><strong>#3 &#8211; Fleet Safety: Peak Performance Strategies for Drivers</strong></h1>
<p>With vehicular accidents costing employers $60 billion per year in property damage, legal and medical expense as well as the loss of worker productivity, employee training and development will always be the key factor in keeping drivers safe, while also protecting your companies’ bottom line.</p>
<p>Nothing delivers the importance of safety better than a compelling personal story. Neuroscience studies confirm storytelling illuminates parts of the brain that are only active when a listener actually experiences something – triggering their imagination, engaging them with a deep emotional response and sealing it into subconscious memory. With these areas of the brain activated and connected by a physical and emotional response, memory retention has been shown to be up to 7 times more effective than training through facts and figures.</p>
<p><strong>Key Program Takeaways:</strong></p>
<ul>
<li>Understand the method for creating a laser-focused mindset that will help drivers minimize road distractions and heighten awareness</li>
<li>Learn how to communicate a shared company vision that will impact drivers to take safety seriously</li>
<li>Discover adaptation strategies that will increase employee buy-in and crush resistance to safety protocols</li>
</ul>
<h1>Customer Reviews</h1>
<div class="pmc-quote">
<p>“Words cannot express my appreciation to you for the presentations you gave to our associates over the course of two days. I heard nothing but positive comments. One person told me, “I don’t know what you paid Scott for our workforce safety meeting, but he was worth every penny!” I would say the standing ovations conveyed how strongly our associates felt about your presentation. You certainly helped us attain our goal of “challenging and inspiring our associates to be the best they could be every day and to make workforce safety a number one priority!” ”</p>
<h5><em>Phillips-Van Heusen Corporation<br />
</em><img decoding="async" class="alignnone wp-image-1187" src="https://charliemorecraft.com/wp-content/uploads/2021/03/Google-Calisthenics-Family.png" sizes="(max-width: 120px) 100vw, 120px" srcset="https://charliemorecraft.com/wp-content/uploads/2021/03/Google-Calisthenics-Family.png 1000w, https://charliemorecraft.com/wp-content/uploads/2021/03/Google-Calisthenics-Family-300x75.png 300w, https://charliemorecraft.com/wp-content/uploads/2021/03/Google-Calisthenics-Family-768x192.png 768w, https://charliemorecraft.com/wp-content/uploads/2021/03/Google-Calisthenics-Family-240x60.png 240w, https://charliemorecraft.com/wp-content/uploads/2021/03/Google-Calisthenics-Family-600x150.png 600w" alt="" width="120" height="30" /></h5>
</div>
<div class="pmc-quote">
<p>“Scott was amazing and had our participants on the edge of their seats. After a long day of meetings and presentations, Scott was able to capture their hearts and minds with his incredible storytelling and relatable style. We appreciated that Scott could tailor his presentation to our meeting themes and bring to life the mindset that we wanted to cultivate through his unique life story and the grit he used to overcome seemingly impossible circumstances.”</p>
<h5><em>BASF Construction Chemicals, Americas<br />
</em><img decoding="async" class="alignnone wp-image-1187" src="https://charliemorecraft.com/wp-content/uploads/2021/03/Google-Calisthenics-Family.png" sizes="(max-width: 120px) 100vw, 120px" srcset="https://charliemorecraft.com/wp-content/uploads/2021/03/Google-Calisthenics-Family.png 1000w, https://charliemorecraft.com/wp-content/uploads/2021/03/Google-Calisthenics-Family-300x75.png 300w, https://charliemorecraft.com/wp-content/uploads/2021/03/Google-Calisthenics-Family-768x192.png 768w, https://charliemorecraft.com/wp-content/uploads/2021/03/Google-Calisthenics-Family-240x60.png 240w, https://charliemorecraft.com/wp-content/uploads/2021/03/Google-Calisthenics-Family-600x150.png 600w" alt="" width="120" height="30" /></h5>
</div>
<div class="pmc-quote">
<p>“Scott quickly understood the nature of our business and some of the opportunities and challenges we were facing and was able relate that back to his experience recovering from his accident. Scott was undoubtedly the highlight as he absolutely captivated the audience and got several standing ovations. I can’t recommend Scott highly enough if you are looking for someone who can motivate your team and help relate your company’s challenges with those he has faced. Truly one of the best speakers I have had the pleasure of working with or listening to.”</p>
<h5><em>James Ford, VP, of Category Strategic Advisory, The Coca-Cola Company<br />
</em><img decoding="async" class="alignnone wp-image-1187" src="https://charliemorecraft.com/wp-content/uploads/2021/03/Google-Calisthenics-Family.png" sizes="(max-width: 120px) 100vw, 120px" srcset="https://charliemorecraft.com/wp-content/uploads/2021/03/Google-Calisthenics-Family.png 1000w, https://charliemorecraft.com/wp-content/uploads/2021/03/Google-Calisthenics-Family-300x75.png 300w, https://charliemorecraft.com/wp-content/uploads/2021/03/Google-Calisthenics-Family-768x192.png 768w, https://charliemorecraft.com/wp-content/uploads/2021/03/Google-Calisthenics-Family-240x60.png 240w, https://charliemorecraft.com/wp-content/uploads/2021/03/Google-Calisthenics-Family-600x150.png 600w" alt="" width="120" height="30" /></h5>
</div>
<div class="pmc-quote">
<p>“Scott Burrows keynote speech was incredibly inspiring and motivating for our employees in our mission to bring safety in the workplace and manage injuries to their best outcomes. Scott was unique in that he did the research on our company and interspersed keen comparisons of our company’s challenges into his own life’s lessons on safety, not being afraid to fail and never quitting. This made Scott’s captivating, challenging message an even more personal and meaningful one for our employees. I highly recommend Scott as a motivational speaker for any company, and especially a company interested in increasing their safety culture.”</p>
<h5><em>James (Jim) C. Owen President and CEO, Missouri Employers Mutual<br />
</em><img decoding="async" class="alignnone wp-image-1187" src="https://charliemorecraft.com/wp-content/uploads/2021/03/Google-Calisthenics-Family.png" sizes="(max-width: 120px) 100vw, 120px" srcset="https://charliemorecraft.com/wp-content/uploads/2021/03/Google-Calisthenics-Family.png 1000w, https://charliemorecraft.com/wp-content/uploads/2021/03/Google-Calisthenics-Family-300x75.png 300w, https://charliemorecraft.com/wp-content/uploads/2021/03/Google-Calisthenics-Family-768x192.png 768w, https://charliemorecraft.com/wp-content/uploads/2021/03/Google-Calisthenics-Family-240x60.png 240w, https://charliemorecraft.com/wp-content/uploads/2021/03/Google-Calisthenics-Family-600x150.png 600w" alt="" width="120" height="30" /></h5>
</div>
<h1>Book presentation</h1>
<p>To inquire about Scott’s presentations please call our office at (800) 783-0796, contact us by email at info@charliemorecraft.com or fill out the form below.</p>
<script src="https://cdn03.jotfor.ms/static/prototype.forms.js?3.3.39252" type="text/javascript"></script>
<script src="https://cdn01.jotfor.ms/static/jotform.forms.js?3.3.39252" type="text/javascript"></script>
<script type="text/javascript">	JotForm.newDefaultTheme = false;
	JotForm.extendsNewTheme = false;
	JotForm.singleProduct = false;
	JotForm.newPaymentUIForNewCreatedForms = false;
	JotForm.highlightInputs = false;

	JotForm.init(function(){
	/*INIT-START*/
if (window.JotForm && JotForm.accessible) $('input_20').setAttribute('tabindex',0);
if (window.JotForm && JotForm.accessible) $('input_3').setAttribute('tabindex',0);
if (window.JotForm && JotForm.accessible) $('input_9').setAttribute('tabindex',0);
if (window.JotForm && JotForm.accessible) $('input_10').setAttribute('tabindex',0);
if (window.JotForm && JotForm.accessible) $('input_11').setAttribute('tabindex',0);
if (window.JotForm && JotForm.accessible) $('input_25').setAttribute('tabindex',0);
if (window.JotForm && JotForm.accessible) $('input_19').setAttribute('tabindex',0);
      JotForm.alterTexts({"ageVerificationError":"You must be older than {minAge} years old to submit this form.","alphabetic":"This field can only contain letters","alphanumeric":"This field can only contain letters and numbers.","appointmentSelected":"You’ve selected {time} on {date}","ccDonationMinLimitError":"Minimum amount is {minAmount} {currency}","ccInvalidCVC":"CVC number is invalid.","ccInvalidExpireDate":"Expire date is invalid.","ccInvalidExpireMonth":"Expiration month is invalid.","ccInvalidExpireYear":"Expiration year is invalid.","ccInvalidNumber":"Credit Card Number is invalid.","ccMissingDetails":"Please fill up the credit card details.","ccMissingDonation":"Please enter numeric values for donation amount.","ccMissingProduct":"Please select at least one product.","characterLimitError":"Too many Characters.  The limit is","characterMinLimitError":"Too few characters. The minimum is","confirmClearForm":"Are you sure you want to clear the form","confirmEmail":"E-mail does not match","currency":"This field can only contain currency values.","cyrillic":"This field can only contain cyrillic characters","dateInvalid":"This date is not valid. The date format is {format}","dateInvalidSeparate":"This date is not valid. Enter a valid {element}.","dateLimited":"This date is unavailable.","disallowDecimals":"Please enter a whole number.","doneButton":"Done","doneMessage":"Well done! All errors are fixed.","dragAndDropFilesHere_infoMessage":"Drag and drop files here","email":"Enter a valid e-mail address","fillMask":"Field value must fill mask.","freeEmailError":"Free email accounts are not allowed","generalError":"There are errors on the form. Please fix them before continuing.","generalPageError":"There are errors on this page. Please fix them before continuing.","geoNotAvailableDesc":"Location provider not available. Please enter the address manually.","geoNotAvailableTitle":"Position Unavailable","geoPermissionDesc":"Check your browser's privacy settings.","geoPermissionTitle":"Permission Denied","geoTimeoutDesc":"Please check your internet connection and try again.","geoTimeoutTitle":"Timeout","gradingScoreError":"Score total should only be less than or equal to","incompleteFields":"There are incomplete required fields. Please complete them.","inputCarretErrorA":"Input should not be less than the minimum value:","inputCarretErrorB":"Input should not be greater than the maximum value:","justSoldOut":"Just Sold Out","lessThan":"Your score should be less than or equal to","maxDigitsError":"The maximum digits allowed is","maxFileSize_infoMessage":"Max. file size","maxSelectionsError":"The maximum number of selections allowed is ","minCharactersError":"The number of characters should not be less than the minimum value:","minSelectionsError":"The minimum required number of selections is ","multipleError":"There are {count} errors in this page. Please correct them before moving on.","multipleFileUploads_emptyError":"{file} is empty, please select files again without it.","multipleFileUploads_fileLimitError":"Only {fileLimit} file uploads allowed.","multipleFileUploads_minSizeError":"{file} is too small, minimum file size is {minSizeLimit}.","multipleFileUploads_onLeave":"The files are being uploaded, if you leave now the upload will be cancelled.","multipleFileUploads_sizeError":"{file} is too large, maximum file size is {sizeLimit}.","multipleFileUploads_typeError":"{file} has invalid extension. Only {extensions} are allowed.","multipleFileUploads_uploadFailed":"File upload failed, please remove it and upload the file again.","noSlotsAvailable":"No slots available","notEnoughStock":"Not enough stock for the current selection","notEnoughStock_remainedItems":"Not enough stock for the current selection ({count} items left)","noUploadExtensions":"File has no extension file type (e.g. .txt, .png, .jpeg)","numeric":"This field can only contain numeric values","oneError":"There is {count} error in this page. Please correct it before moving on.","pastDatesDisallowed":"Date must not be in the past.","pleaseWait":"Please wait...","required":"This field is required.","requiredLegend":"All fields marked with * are required and must be filled.","requireEveryCell":"Every cell is required.","requireEveryRow":"Every row is required.","requireOne":"At least one field required.","restrictedDomain":"This domain is not allowed","seeErrorsButton":"See Errors","selectionSoldOut":"Selection Sold Out","slotUnavailable":"{time} on {date} has been selected is unavailable. Please select another slot.","soldOut":"Sold Out","subProductItemsLeft":"({count} items left)","uploadExtensions":"You can only upload following files:","uploadFilesize":"File size cannot be bigger than:","uploadFilesizemin":"File size cannot be smaller than:","url":"This field can only contain a valid URL","validateEmail":"You need to validate this e-mail","wordLimitError":"Too many words. The limit is","wordMinLimitError":"Too few words.  The minimum is"});
      FormTranslation.init({"detectUserLanguage":"1","firstPageOnly":"0","options":"English (US)","originalLanguage":"en","primaryLanguage":"en","saveUserLanguage":"1","showStatus":"flag-with-nation","theme":"light-theme","version":"2"});
	/*INIT-END*/
	});

   JotForm.prepareCalculationsOnTheFly([null,null,null,{"name":"firstName","qid":"3","text":"First Name","type":"control_textbox"},null,null,null,null,{"name":"submit","qid":"8","text":"Submit","type":"control_button"},{"name":"lastName","qid":"9","text":"Last Name","type":"control_textbox"},{"name":"email10","qid":"10","text":"E-mail","type":"control_textbox"},{"name":"phone","qid":"11","text":"Phone","type":"control_textbox"},null,null,null,null,null,null,null,{"name":"otherDetails","qid":"19","text":"Other Details","type":"control_textarea"},{"description":"","name":"company","qid":"20","subLabel":"","text":"Company","type":"control_textbox"},{"description":"","name":"pleaseVerify","qid":"21","text":"Please verify that you are human","type":"control_captcha"},null,{"name":"input23","qid":"23","text":"Bring Keynote Scott Burrows to your facility to deliver a very powerful, profound and impactful safety message that will alter people’s attitude towards safety forever! GUARANTEED!\nFor pricing and availability please send us an email at info@charliemorecraft.com or fill out the form below.\nContact Details: +1 (561) 997-1120Toll Free: (800) 783-0796Email: info@charliemorecraft.com Website: https:\u002F\u002Fcharliemorecraft.com\u002Fon-site-presentations-with-scott-burrows-motivational-safety-speaker\u002F ","type":"control_text"},null,{"description":"","name":"eventDates","qid":"25","subLabel":"","text":"Event Date(s) and\u002For Location(s)","type":"control_textarea"},{"description":"","name":"keynoteSafety","qid":"26","subLabel":"","text":"Keynote Safety Speaker","type":"control_dropdown"}]);
   setTimeout(function() {
JotForm.paymentExtrasOnTheFly([null,null,null,{"name":"firstName","qid":"3","text":"First Name","type":"control_textbox"},null,null,null,null,{"name":"submit","qid":"8","text":"Submit","type":"control_button"},{"name":"lastName","qid":"9","text":"Last Name","type":"control_textbox"},{"name":"email10","qid":"10","text":"E-mail","type":"control_textbox"},{"name":"phone","qid":"11","text":"Phone","type":"control_textbox"},null,null,null,null,null,null,null,{"name":"otherDetails","qid":"19","text":"Other Details","type":"control_textarea"},{"description":"","name":"company","qid":"20","subLabel":"","text":"Company","type":"control_textbox"},{"description":"","name":"pleaseVerify","qid":"21","text":"Please verify that you are human","type":"control_captcha"},null,{"name":"input23","qid":"23","text":"Bring Keynote Scott Burrows to your facility to deliver a very powerful, profound and impactful safety message that will alter people’s attitude towards safety forever! GUARANTEED!\nFor pricing and availability please send us an email at info@charliemorecraft.com or fill out the form below.\nContact Details: +1 (561) 997-1120Toll Free: (800) 783-0796Email: info@charliemorecraft.com Website: https:\u002F\u002Fcharliemorecraft.com\u002Fon-site-presentations-with-scott-burrows-motivational-safety-speaker\u002F ","type":"control_text"},null,{"description":"","name":"eventDates","qid":"25","subLabel":"","text":"Event Date(s) and\u002For Location(s)","type":"control_textarea"},{"description":"","name":"keynoteSafety","qid":"26","subLabel":"","text":"Keynote Safety Speaker","type":"control_dropdown"}]);}, 20); 
</script>
<link href="https://cdn01.jotfor.ms/static/formCss.css?3.3.39252" rel="stylesheet" type="text/css" />
<style type="text/css">@media print{.form-section{display:inline!important}.form-pagebreak{display:none!important}.form-section-closed{height:auto!important}.page-section{position:initial!important}}</style>
<link type="text/css" rel="stylesheet" href="https://cdn02.jotfor.ms/css/styles/nova.css?3.3.39252" />
<link type="text/css" rel="stylesheet" href="https://cdn03.jotfor.ms/themes/CSS/566a91c2977cdfcd478b4567.css?themeRevisionID=58c6459d9a11c7136a8b4567"/>
<link type="text/css" rel="stylesheet" href="https://cdn01.jotfor.ms/css/styles/payment/payment_feature.css?3.3.39252" />
<style type="text/css">


    .form-label-left{
        width:150px;
    }
    .form-line{
        padding-top:5px;
        padding-bottom:5px;
    }
    .form-label-right{
        width:150px;
    }
    .form-all{
        width:480px;
        color:#555 !important;
        font-family:'Roboto';
        font-size:14px;
    }
    .form-radio-item label, .form-checkbox-item label, .form-grading-label, .form-header{
        color: #0D0D0D;
    }

</style>

<style type="text/css" id="form-designer-style">
@import "https://fonts.googleapis.com/css?family=Roboto:light,lightitalic,normal,italic,bold,bolditalic";
@import (css) "@{buttonFontLink}";
    /* Injected CSS Code */

.form-all {
  font-family: "Roboto", sans-serif;
}
.form-all {
  width: 480px;
}
.form-label-left,
.form-label-right {
  width: 150px;
}
.form-label {
  white-space: normal;
}
.form-label.form-label-auto {
  display: block;
  float: none;
  text-align: left;
}
.form-label-left {
  display: inline-block;
  white-space: normal;
  float: left;
  text-align: left;
}
.form-label-right {
  display: inline-block;
  white-space: normal;
  float: left;
  text-align: right;
}
.form-label-top {
  white-space: normal;
  display: block;
  float: none;
  text-align: left;
}
.form-radio-item label:before {
  top: 0;
}
.form-all {
  font-size: 14px;
}
.form-label {
  font-weight: normal;
  font-size: 0.95em;
}
.supernova {
  background-color: #ffffff;
}
.supernova body {
  background-color: transparent;
}
/*
@width30: (unit(@formWidth, px) + 60px);
@width60: (unit(@formWidth, px)+ 120px);
@width90: (unit(@formWidth, px)+ 180px);
*/
/* | */
@media screen and (min-width: 480px) {
  .supernova .form-all {
    border: 1px solid #e6e6e6;
    -webkit-box-shadow: 0 3px 9px rgba(0, 0, 0, 0.1);
    -moz-box-shadow: 0 3px 9px rgba(0, 0, 0, 0.1);
    box-shadow: 0 3px 9px rgba(0, 0, 0, 0.1);
  }
}
/* | */
/* | */
@media screen and (max-width: 480px) {
  .jotform-form {
    padding: 10px 0;
  }
}
/* | */
/* | */
@media screen and (min-width: 480px) and (max-width: 768px) {
  .jotform-form {
    padding: 30px 0;
  }
}
/* | */
/* | */
@media screen and (min-width: 480px) and (max-width: 479px) {
  .jotform-form {
    padding: 30px 0;
  }
}
/* | */
/* | */
@media screen and (min-width: 768px) {
  .jotform-form {
    padding: 60px 0;
  }
}
/* | */
/* | */
@media screen and (max-width: 479px) {
  .jotform-form {
    padding: 12px;
  }
}
/* | */
.supernova .form-all,
.form-all {
  background-color: #ffffff;
  border: 1px solid transparent;
}
.form-header-group {
  border-color: #e6e6e6;
}
.form-matrix-table tr {
  border-color: #e6e6e6;
}
.form-matrix-table tr:nth-child(2n) {
  background-color: #f2f2f2;
}
.form-all {
  color: #555555;
}
.form-header-group .form-header {
  color: #555555;
}
.form-header-group .form-subHeader {
  color: #6f6f6f;
}
.form-sub-label {
  color: #6f6f6f;
}
.form-label-top,
.form-label-left,
.form-label-right,
.form-html {
  color: #6f6f6f;
}
.form-checkbox-item label,
.form-radio-item label {
  color: #555555;
}
.form-line.form-line-active {
  -webkit-transition-property: all;
  -moz-transition-property: all;
  -ms-transition-property: all;
  -o-transition-property: all;
  transition-property: all;
  -webkit-transition-duration: 0.3s;
  -moz-transition-duration: 0.3s;
  -ms-transition-duration: 0.3s;
  -o-transition-duration: 0.3s;
  transition-duration: 0.3s;
  -webkit-transition-timing-function: ease;
  -moz-transition-timing-function: ease;
  -ms-transition-timing-function: ease;
  -o-transition-timing-function: ease;
  transition-timing-function: ease;
  background-color: rgba(255, 255, 224, 0);
}
/* omer */
.form-radio-item,
.form-checkbox-item {
  padding-bottom: 0px !important;
}
.form-radio-item:last-child,
.form-checkbox-item:last-child {
  padding-bottom: 0;
}
/* omer */
.form-single-column .form-checkbox-item,
.form-single-column .form-radio-item {
  width: 100%;
}
.supernova {
  height: 100%;
  background-repeat: no-repeat;
  background-attachment: scroll;
  background-position: center top;
  background-repeat: repeat;
}
.supernova {
  background-image: none;
}
#stage {
  background-image: none;
}
/* | */
.form-all {
  background-repeat: no-repeat;
  background-attachment: scroll;
  background-position: center top;
  background-repeat: repeat;
}
.form-header-group {
  background-repeat: no-repeat;
  background-attachment: scroll;
  background-position: center top;
}
.form-line {
  margin-top: 0px;
  margin-bottom: 0px;
}
.form-line {
  padding: 8px 36px;
}
.form-all .form-textbox,
.form-all .form-radio-other-input,
.form-all .form-checkbox-other-input,
.form-all .form-captcha input,
.form-all .form-spinner input,
.form-all .form-pagebreak-back,
.form-all .form-pagebreak-next,
.form-all .qq-upload-button,
.form-all .form-error-message {
  -webkit-border-radius: 6px;
  -moz-border-radius: 6px;
  border-radius: 6px;
}
.form-all .form-sub-label {
  margin-left: 3px;
}
.form-all .form-textarea {
  -webkit-border-radius: 6px;
  -moz-border-radius: 6px;
  border-radius: 6px;
}
.form-all {
  -webkit-border-radius: 6px;
  -moz-border-radius: 6px;
  border-radius: 6px;
}
.form-section:first-child {
  -webkit-border-radius: 6px 6px 0 0;
  -moz-border-radius: 6px 6px 0 0;
  border-radius: 6px 6px 0 0;
}
.form-section:last-child {
  -webkit-border-radius: 0 0 6px 6px;
  -moz-border-radius: 0 0 6px 6px;
  border-radius: 0 0 6px 6px;
}
.form-all .qq-upload-button,
.form-all .form-submit-button,
.form-all .form-submit-reset,
.form-all .form-submit-print {
  font-size: 1em;
  padding: 9px 15px;
  font-family: "Roboto", sans-serif;
  font-size: 14px;
  font-weight: normal;
}
.form-all .form-pagebreak-back,
.form-all .form-pagebreak-next {
  font-size: 1em;
  padding: 9px 15px;
  font-family: "Roboto", sans-serif;
  font-size: 14px;
  font-weight: normal;
}
/*
& when ( @buttonFontType = google ) {
	
}
*/
h2.form-header {
  line-height: 1.618em;
  font-size: 1.714em;
}
h2 ~ .form-subHeader {
  line-height: 1.5em;
  font-size: 1.071em;
}
.form-header-group {
  text-align: left;
}
/*.form-dropdown,
.form-radio-item,
.form-checkbox-item,
.form-radio-other-input,
.form-checkbox-other-input,*/
.form-captcha input,
.form-spinner input,
.form-error-message {
  padding: 4px 3px 2px 3px;
}
.form-header-group {
  font-family: "Roboto", sans-serif;
}
.form-section {
  padding: 0px 0px 0px 0px;
}
.form-header-group {
  margin: 0px 0px 0px 0px;
}
.form-header-group {
  padding: 12px 36px 12px 36px;
}
.form-header-group {
  background-color: #f5f5f5;
}
.form-textbox,
.form-textarea {
  padding: 4px 3px 2px 3px;
}
.form-textbox,
.form-textarea,
.form-radio-other-input,
.form-checkbox-other-input,
.form-captcha input,
.form-spinner input {
  background-color: #ffffff;
}
[data-type="control_dropdown"] .form-input,
[data-type="control_dropdown"] .form-input-wide {
  width: 150px;
}
.form-label {
  font-family: "Roboto", sans-serif;
}
li[data-type="control_image"] div {
  text-align: left;
}
li[data-type="control_image"] img {
  border: none;
  border-width: 0px !important;
  border-style: solid !important;
  border-color: false !important;
}
.form-line-column {
  width: auto;
}
.form-line-error {
  background-color: #ffffff;
  -webkit-box-shadow: inset 0px 3px 11px -7px #ff3200;
  -moz-box-shadow: inset 0px 3px 11px -7px #ff3200;
  box-shadow: inset 0px 3px 11px -7px #ff3200;
}
.form-line-error input:not(#coupon-input),
.form-line-error textarea,
.form-line-error .form-validation-error {
  -webkit-transition-property: none;
  -moz-transition-property: none;
  -ms-transition-property: none;
  -o-transition-property: none;
  transition-property: none;
  -webkit-transition-duration: 0.3s;
  -moz-transition-duration: 0.3s;
  -ms-transition-duration: 0.3s;
  -o-transition-duration: 0.3s;
  transition-duration: 0.3s;
  -webkit-transition-timing-function: ease;
  -moz-transition-timing-function: ease;
  -ms-transition-timing-function: ease;
  -o-transition-timing-function: ease;
  transition-timing-function: ease;
  border: 1px solid #fff4f4;
  -moz-box-shadow: 0 0 3px #fff4f4;
  -webkit-box-shadow: 0 0 3px #fff4f4;
  box-shadow: 0 0 3px #fff4f4;
}
.form-line-error .form-error-message {
  margin: 0;
  position: absolute;
  color: #fff;
  display: inline-block;
  right: 0;
  font-size: 10px;
  position: absolute!important;
  box-shadow: none;
  top: 0px;
  line-height: 20px;
  color: #FFF;
  background: #ff3200;
  padding: 0px 5px;
  bottom: auto;
  min-width: 105px;
  -webkit-border-radius: 0;
  -moz-border-radius: 0;
  border-radius: 0;
}
.form-line-error .form-error-message img,
.form-line-error .form-error-message .form-error-arrow {
  display: none;
}
.ie-8 .form-all {
  margin-top: auto;
  margin-top: initial;
}
.ie-8 .form-all:before {
  display: none;
}
/* | */
@media screen and (max-width: 480px), screen and (max-device-width: 768px) and (orientation: portrait), screen and (max-device-width: 415px) and (orientation: landscape) {
  .testOne {
    letter-spacing: 0;
  }
  .jotform-form {
    padding: 12px 0 0 0;
  }
  .form-all {
    border: 0;
    width: 94%!important;
    max-width: initial;
  }
  .form-sub-label-container {
    width: 100%;
    margin: 0;
    margin-right: 0;
    float: left;
    -moz-box-sizing: border-box;
    -webkit-box-sizing: border-box;
    box-sizing: border-box;
  }
  span.form-sub-label-container + span.form-sub-label-container {
    margin-right: 0;
  }
  .form-sub-label {
    white-space: normal;
  }
  .form-address-table td,
  .form-address-table th {
    padding: 0 1px 10px;
  }
  .form-submit-button,
  .form-submit-print,
  .form-submit-reset {
    width: 100%;
    margin-left: 0!important;
  }
  div[id*=at_] {
    font-size: 14px;
    font-weight: 700;
    height: 8px;
    margin-top: 6px;
  }
  .showAutoCalendar {
    width: 20px;
  }
  img.form-image {
    max-width: 100%;
    height: auto;
  }
  .form-matrix-row-headers {
    width: 100%;
    word-break: break-all;
    min-width: 40px;
  }
  .form-collapse-table,
  .form-header-group {
    margin: 0;
  }
  .form-collapse-table {
    height: 100%;
    display: inline-block;
    width: 100%;
  }
  .form-collapse-hidden {
    display: none !important;
  }
  .form-input {
    width: 100%;
  }
  .form-label {
    width: 100% !important;
  }
  .form-label-left,
  .form-label-right {
    display: block;
    float: none;
    text-align: left;
    width: auto!important;
  }
  .form-line,
  .form-line.form-line-column {
    padding: 2% 5%;
    -moz-box-sizing: border-box;
    -webkit-box-sizing: border-box;
    box-sizing: border-box;
  }
  input[type=text],
  input[type=email],
  input[type=tel],
  textarea {
    width: 100%;
    -moz-box-sizing: border-box;
    -webkit-box-sizing: border-box;
    box-sizing: border-box;
    max-width: initial !important;
  }
  .form-dropdown,
  .form-textarea,
  .form-textbox {
    width: 100%!important;
    -moz-box-sizing: border-box;
    -webkit-box-sizing: border-box;
    box-sizing: border-box;
  }
  .form-input,
  .form-input-wide,
  .form-textarea,
  .form-textbox,
  .form-dropdown {
    max-width: initial!important;
  }
  .form-address-city,
  .form-address-line,
  .form-address-postal,
  .form-address-state,
  .form-address-table,
  .form-address-table .form-sub-label-container,
  .form-address-table select,
  .form-input {
    width: 100%;
  }
  div.form-header-group {
    padding: 12px 36px !important;
    padding-left: 5%!important;
    padding-right: 5%!important;
    margin: 0 0px 2% !important;
    -moz-box-sizing: border-box;
    -webkit-box-sizing: border-box;
    box-sizing: border-box;
  }
  div.form-header-group.hasImage img {
    max-width: 100%;
  }
  [data-type="control_button"] {
    margin-bottom: 0 !important;
  }
  [data-type=control_fullname] .form-sub-label-container {
    width: 48%;
  }
  [data-type=control_fullname] .form-sub-label-container:first-child {
    margin-right: 4%;
  }
  [data-type=control_phone] .form-sub-label-container {
    width: 65%;
  }
  [data-type=control_phone] .form-sub-label-container:first-child {
    width: 31%;
    margin-right: 4%;
  }
  [data-type=control_datetime] .form-sub-label-container + .form-sub-label-container,
  [data-type=control_datetime] .form-sub-label-container:first-child {
    width: 27.3%;
    margin-right: 6%;
  }
  [data-type=control_datetime] .form-sub-label-container + .form-sub-label-container + .form-sub-label-container {
    width: 33.3%;
    margin-right: 0;
  }
  [data-type=control_datetime] span + span + span > span:first-child {
    display: block;
    width: 100% !important;
  }
  [data-type=control_birthdate] .form-sub-label-container,
  [data-type=control_datetime] span + span + span > span:first-child + span + span,
  [data-type=control_time] .form-sub-label-container {
    width: 27.3%!important;
    margin-right: 6% !important;
  }
  [data-type=control_birthdate] .form-sub-label-container:last-child,
  [data-type=control_time] .form-sub-label-container:last-child {
    width: 33.3%!important;
    margin-right: 0 !important;
  }
  .form-pagebreak-back-container,
  .form-pagebreak-next-container {
    width: 50% !important;
  }
  .form-pagebreak-back,
  .form-pagebreak-next,
  .form-product-item.hover-product-item {
    width: 100%;
  }
  .form-pagebreak-back-container {
    padding: 0;
    text-align: right;
  }
  .form-pagebreak-next-container {
    padding: 0;
    text-align: left;
  }
  .form-pagebreak {
    margin: 0 auto;
  }
  .form-buttons-wrapper {
    margin: 0!important;
    margin-left: 0!important;
  }
  .form-buttons-wrapper button {
    width: 100%;
  }
  .form-buttons-wrapper .form-submit-print {
    margin: 0 !important;
  }
  table {
    width: 100%!important;
    max-width: initial!important;
  }
  table td + td {
    padding-left: 3%;
  }
  .form-checkbox-item,
  .form-radio-item {
    white-space: normal!important;
  }
  .form-checkbox-item input,
  .form-radio-item input {
    width: auto;
  }
  .form-collapse-table {
    margin: 0 5%;
    display: block;
    zoom: 1;
    width: auto;
  }
  .form-collapse-table:before,
  .form-collapse-table:after {
    display: table;
    content: '';
    line-height: 0;
  }
  .form-collapse-table:after {
    clear: both;
  }
  .fb-like-box {
    width: 98% !important;
  }
  .form-error-message {
    clear: both;
    bottom: -10px;
  }
  .date-separate,
  .phone-separate {
    display: none;
  }
  .custom-field-frame,
  .direct-embed-widgets,
  .signature-pad-wrapper {
    width: 100% !important;
  }
}
/* | */

/*PREFERENCES STYLE*/
    .form-all {
      font-family: Roboto, sans-serif;
    }
    .form-all .qq-upload-button,
    .form-all .form-submit-button,
    .form-all .form-submit-reset,
    .form-all .form-submit-print {
      font-family: Roboto, sans-serif;
    }
    .form-all .form-pagebreak-back-container,
    .form-all .form-pagebreak-next-container {
      font-family: Roboto, sans-serif;
    }
    .form-header-group {
      font-family: Roboto, sans-serif;
    }
    .form-label {
      font-family: Roboto, sans-serif;
    }
  
    .form-label.form-label-auto {
      
    display: block;
    float: none;
    text-align: left;
    width: 100%;
  
    }
  
    .form-line {
      margin-top: 5px;
      margin-bottom: 5px;
    }
  
    .form-all {
      max-width: 480px;
      width: 100%;
    }
  
    .form-label.form-label-left,
    .form-label.form-label-right,
    .form-label.form-label-left.form-label-auto,
    .form-label.form-label-right.form-label-auto {
      width: 150px;
    }
  
    .form-all {
      font-size: 14px
    }
    .form-all .qq-upload-button,
    .form-all .qq-upload-button,
    .form-all .form-submit-button,
    .form-all .form-submit-reset,
    .form-all .form-submit-print {
      font-size: 14px
    }
    .form-all .form-pagebreak-back-container,
    .form-all .form-pagebreak-next-container {
      font-size: 14px
    }
  
    .supernova .form-all, .form-all {
      background-color: #fff;
    }
  
    .form-all {
      color: #555;
    }
    .form-header-group .form-header {
      color: #555;
    }
    .form-header-group .form-subHeader {
      color: #555;
    }
    .form-label-top,
    .form-label-left,
    .form-label-right,
    .form-html,
    .form-checkbox-item label,
    .form-radio-item label,
    span.FITB .qb-checkbox-label,
    span.FITB .qb-radiobox-label,
    span.FITB .form-radio label,
    span.FITB .form-checkbox label,
    [data-blotid][data-type=checkbox] [data-labelid],
    [data-blotid][data-type=radiobox] [data-labelid],
    span.FITB-inptCont[data-type=checkbox] label,
    span.FITB-inptCont[data-type=radiobox] label {
      color: #555;
    }
    .form-sub-label {
      color: #6f6f6f;
    }
  
    .supernova {
      background-color: rgb(255, 255, 255);
    }
    .supernova body {
      background: transparent;
    }
  
    .form-textbox,
    .form-textarea,
    .form-dropdown,
    .form-radio-other-input,
    .form-checkbox-other-input,
    .form-captcha input,
    .form-spinner input {
      background-color: #fff;
    }
  
    .supernova {
      background-image: none;
    }
    #stage {
      background-image: none;
    }
  
    .form-all {
      background-image: none;
    }
  
    .form-all {
      position: relative;
    }
    .form-all:before {
      content: "";
      background-image: url("https://www.jotform.com/uploads/WEBSITEFLIX/form_files/scott-burrows-keynote-safety-speaker-.63eabfe2e79174.75833059.jpg");
      display: inline-block;
      height: 212.65822784810126px;
      position: absolute;
      background-size: 480px 212px;
      background-repeat: no-repeat;
      width: 100%;
    }
    .form-all {
      margin-top: 222px !important;
    }
    .form-all:before {
      top: -222px;
      background-position: top center;
      left: 0;
    }
           
  .ie-8 .form-all:before { display: none; }
  .ie-8 {
    margin-top: auto;
    margin-top: initial;
  }
  
  /*PREFERENCES STYLE*//*__INSPECT_SEPERATOR__*/
/*---------------------
Theme: Generic Theme
Author: Elton Cris - idarktech@jotform.com
www.jotform.com
----------------------*/
.form-all {
    -moz-box-sizing : border-box;
    -webkit-box-sizing : border-box;
    box-sizing : border-box;
    -moz-box-shadow : 0 1px 4px rgba(0, 0, 0, .25);
    -webkit-box-shadow : 0 1px 4px rgba(0, 0, 0, .25);
    box-shadow : 0 1px 4px rgba(0, 0, 0, .25) !important;
}

[data-type="control_head"] {
    padding-bottom : 20px;
}

/*responsive fields*/
[data-type="control_textbox"] .form-textbox, 
[data-type="control_fullname"] .form-textbox,
[data-type="control_email"] .form-textbox,
[data-type="control_textarea"] .form-textarea, 
[data-type="control_dropdown"] .form-dropdown {
    width : 100% !important;
    max-width : none !important;
}

.form-textbox, .form-textarea, .form-dropdown {
    max-width : none !important;
    box-shadow : none;
    outline : none;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
    -moz-box-sizing : border-box;
    font-family : inherit;
    padding : 8px;
    transition : .3s ease-in-out;
    box-shadow : 0 1px 2px rgba(0, 0, 0, .15) inset;
}

.form-textarea-limit>span {
    display : block;
}

[data-type="control_dropdown"] .form-input, 
[data-type="control_dropdown"] .form-input-wide {
    width : 100%;
}

/*input focus*/
.form-line-active input:focus, .form-line-active textarea:focus, .form-line-active select:focus {
    outline : 0;
    border-color : 1px solid rgba(82, 168, 236, 0.8) !important;
    box-shadow : inset 0 1px 3px rgba(0, 0, 0, 0.1),0 0 8px rgba(82, 168, 236, 0.6);
}

/*reset error*/
.form-line-error {
    box-shadow : none;
}

/*input error*/
.form-line-error input:not(#coupon-input), .form-line-error textarea, .form-line-error select, .form-line-error .form-validation-error {
    border : 1px solid #e15353 !important;
    box-shadow : none !important;
}

.form-line-active {
    color : inherit !important;
}

/*responsive content -wide or shrink*/
.form-label {
    width : 35% !important;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
    -moz-box-sizing : border-box;
}

.form-label-top {
    width : 100% !important;
}

.form-line {
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
    -moz-box-sizing : border-box;
    width : 100%;
}

.form-checkbox-other-input {
    width : 80% !important;
}

.form-input {
    width : 65% !important;
    max-width : none !important;
}

.form-input-wide {
    max-width : none !important;
    display : inline-block;
    width : 100%;
}

/*single fields with sublabels*/
[data-type="control_textbox"] .form-input-wide .form-sub-label-container, 
[data-type="control_fullname"] .form-input-wide .form-sub-label-container,
[data-type="control_email"] .form-input-wide .form-sub-label-container,
[data-type="control_textarea"] .form-input-wide .form-sub-label-container, 
[data-type="control_dropdown"] .form-input-wide .form-sub-label-container,
[data-type="control_textbox"] .form-input .form-sub-label-container, 
[data-type="control_fullname"] .form-input .form-sub-label-container,
[data-type="control_email"] .form-input .form-sub-label-container,
[data-type="control_textarea"] .form-input .form-sub-label-container, 
[data-type="control_dropdown"] .form-input .form-sub-label-container {
    width : 100%;
    max-width : none !important;
}

[data-type="control_dropdown"] .form-input-wide {
    width : 100%;
}

/*responsive full name*/
[data-type="control_fullname"] .form-sub-label-container {
    width : 50% !important;
    margin : 0 !important;
    float : left;
    box-sizing : border-box;
}

[data-type="control_fullname"] .form-label + div .form-sub-label-container {
    display : inline-block;
    padding-right : 5px;
}

[data-type="control_fullname"] .form-label + div .form-sub-label-container + .form-sub-label-container {
    margin-right : 0;
    padding-right : 0;
    padding-left : 5px;
}

[data-type="control_fullname"] .form-label + div .form-sub-label-container + .form-sub-label-container {
    margin-right : 0;
    padding-right : 0;
    padding-left : 5px;
}

[data-type="control_fullname"] .form-label + div .form-sub-label-container + .form-sub-label-container + .form-sub-label-container {
    padding-left : 0;
    padding-right : 5px;
}

[data-type="control_fullname"] .form-label + div .form-sub-label-container + .form-sub-label-container + .form-sub-label-container + .form-sub-label-container {
    padding-left : 5px;
    padding-right : 0;
}

[data-type="control_fullname"] .form-label + div .form-sub-label-container + .form-sub-label-container  + .form-sub-label-container + .form-sub-label-container + .form-sub-label-container {
    padding-right : 5px;
    padding-left : 0;
}

#sublabel_prefix, #sublabel_first, #sublabel_middle {
    /*margin-bottom : 10px;
    */;
}

/*remove sepatators on date and phone*/
.phone-separate, .date-separate {
    display : none;
}

/*responsive phone fields*/
[data-type="control_phone"] input[name$="[area]"] {
    width : 100%;
}

[data-type="control_phone"] input[name$="[phone]"] {
    width : 100%;
}

[data-type="control_phone"] input[name$="[full]"] {
    width : 100%;
}

[data-type="control_phone"] .form-sub-label-container {
    width : 40%;
    float : left;
    box-sizing : border-box;
    margin-right : 0;
    padding-right : 12px;
}

/* responsive date time field */
[data-type="control_datetime"] .form-textbox,
[data-type="control_datetime"] .form-dropdown {
    width : 100%;
}

[data-type="control_datetime"] .form-sub-label-container {
    width : 28%;
    padding-left : 4px;
    box-sizing : border-box;
    margin-right : 0;
}

[data-type="control_datetime"] .form-sub-label-container:first-child {
    padding-left : 0;
}

[data-type="control_datetime"] .form-sub-label-container:first-child + .form-sub-label-container + .form-sub-label-container {
    padding-right : 0;
}

[data-type="control_datetime"] .form-sub-label-container:last-child {
    width : auto !important;
}

.allowTime-container .form-sub-label-container:last-child {
    width : 20% !important;
}

span.allowTime-container {
    width : 80%;
    padding-top : 14px;
}

.allowTime-container span.form-sub-label-container {
    width : 35%;
}

span.allowTime-container .form-dropdown {
    width : 100%;
}

span.allowTime-container > span:first-child {
    display : none;
}

span.allowTime-container > span:first-child + span {
    padding-left : 0;
}

.showAutoCalendar + label {
    display : none;
}

span.allowTime-container + span {
    padding-top : 14px;
}

/*calendar lite mode*/
[data-type="control_datetime"] div[style*="none"] + .form-sub-label-container {
    width : 84%;
    padding-left : 0;
}

/*responsive phone field*/
[data-type="control_phone"] .form-sub-label-container + .form-sub-label-container {
    width : 60%;
    margin-right : 0;
    padding-right : 0;
    padding-left : 12px;
}

/*responsive full address fields*/
.form-address-city, .form-address-line, .form-address-postal, 
.form-address-state, .form-address-table, 
.form-address-table .form-sub-label-container, .form-address-table select {
    width : 100%;
    max-width : 100%;
}

[data-type="control_address"] input[name$="[city]"],
[data-type="control_address"] input[name$="[postal]"] {
    width : 90% !important;
}

[data-type="control_address"] input[name$="[area]"] {
    width : 60%;
}

/*reset submit button*/
[data-type="control_button"] {
    background : transparent !important;
}

.form-submit-button,
.form-submit-reset,
.form-submit-print {
    outline : none;
}

/*remove other checkbox*/
.form-checkbox-other, 
.form-radio-other {
    visibility : hidden !important;
}

/*shruken fields*/
.form-line-column {
    width : 50%;
}

.form-line-column .form-label-top {
    width : 100% !important;
}

/*fix form builder display*/
div#stage.form-all {
    max-width : none !important;
    margin-right : 0;
}

div#stage .form-input {
    width : 64% !important;
}

/*remove first pagebreak back button*/
.form-all .page-section:first-child .form-pagebreak .form-pagebreak-back-container {
    display : none !important;
}

/* responsive pagebreak */
.form-pagebreak-back-container {
    width : 50% !important;
    text-align : left;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
    float : left;
}

.form-pagebreak-next-container {
    width : 50% !important;
    text-align : right;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
    float : left;
}

/* radio-checkbox button make border 1px */
.form-radio-item:not(#foo) label:after,
.form-radio-item:not(#foo) label:before {
    border-radius : 50%;
}

.form-checkbox-item:not(#foo) label:after,
.form-checkbox-item:not(#foo) label:before {
    border-radius : 0;
}

.form-radio-item:not(#foo) label:before,
.form-checkbox-item:not(#foo) label:before {
    border-width : 1px;
}

/*responsive credit card on payment fields*/
table td + td {
    padding-left : 0;
}

.form-address-table {
    width : 100%;
}

[data-type="control_stripe"] .form-address-table,
[data-type="control_stripe"] .form-address-table .form-textbox,
[data-type="control_authnet"] .form-address-table,
[data-type="control_authnet"] .form-address-table .form-textbox,
#creditCardTable.form-address-table,
#creditCardTable.form-address-table .form-textbox {
    max-width : none;
}

[data-type="control_stripe"] .form-address-table td:last-child .form-sub-label-container,
[data-type="control_authnet"] .form-address-table td:last-child .form-sub-label-container,
#creditCardTable.form-address-table td:last-child .form-sub-label-container {
    margin-left : 0;
    white-space : normal;
}

[data-type="control_stripe"] .form-address-table td .form-sub-label-container,
[data-type="control_authnet"] .form-address-table td .form-sub-label-container,
#creditCardTable.form-address-table td .form-sub-label-container {
    width : 100%;
}

[data-type="control_stripe"] .form-address-table .form-textbox,
[data-type="control_stripe"] .form-address-table .form-dropdown,
[data-type="control_authnet"] .form-address-table .form-textbox,
[data-type="control_authnet"] .form-address-table .form-dropdown,
#creditCardTable.form-address-table .form-textbox,
#creditCardTable.form-address-table .form-dropdown {
    width : 100%;
    visibility : visible;
}

[data-type="control_stripe"] .form-address-table tbody > tr:first-child + tr td:first-child span,
[data-type="control_authnet"] .form-address-table tbody > tr:first-child + tr td:first-child span,
#creditCardTable.form-address-table tbody > tr:first-child + tr td:first-child span {
    margin : 0;
    padding-right : 6px;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
}

[data-type="control_stripe"] .form-address-table tbody > tr:first-child + tr td:first-child + td span,
[data-type="control_authnet"] .form-address-table tbody > tr:first-child + tr td:first-child + td span,
#creditCardTable.form-address-table tbody > tr:first-child + tr td:first-child + td span {
    margin : 0;
    padding-left : 6px;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
}

[data-type="control_stripe"] .form-address-table tbody > tr:first-child + tr +tr td:first-child span,
[data-type="control_stripe"] .form-address-table tbody > tr:first-child + tr +tr+tr td:first-child span,
[data-type="control_authnet"] .form-address-table tbody > tr:first-child + tr +tr td:first-child span,
[data-type="control_authnet"] .form-address-table tbody > tr:first-child + tr +tr+tr td:first-child span,
#creditCardTable.form-address-table tbody > tr:first-child + tr +tr td:first-child span,
#creditCardTable.form-address-table tbody > tr:first-child + tr +tr+tr td:first-child span {
    margin : 0;
    padding-right : 6px;
    width : 50% !important;
    visibility : hidden;
    float : left;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
}

[data-type="control_stripe"] .form-address-table tbody > tr:first-child + tr +tr td:first-child span + span,
[data-type="control_stripe"] .form-address-table tbody > tr:first-child + tr +tr+tr td:first-child span + span,
[data-type="control_authnet"] .form-address-table tbody > tr:first-child + tr +tr td:first-child span + span,
[data-type="control_authnet"] .form-address-table tbody > tr:first-child + tr +tr+tr td:first-child span + span,
#creditCardTable.form-address-table tbody > tr:first-child + tr +tr td:first-child span + span,
#creditCardTable.form-address-table tbody > tr:first-child + tr +tr+tr td:first-child span + span {
    margin : 0;
    padding-top : 0 !important;
    padding-right : 0;
    padding-left : 6px;
    width : 50% !important;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
}

.cc_ccv {
    width : 100% !important;
}

[data-type="control_stripe"] .form-address-table .form-sub-label,
[data-type="control_authnet"] .form-address-table .form-sub-label,
#creditCardTable.form-address-table .form-sub-label {
    visibility : visible;
}

/*cc fix city state, country */
[data-type="control_stripe"] .form-address-table td[width="50%"]>span:first-child,
[data-type="control_authnet"] .form-address-table td[width="50%"]>span:first-child,
#creditCardTable.form-address-table td[width="50%"]>span:first-child {
    box-sizing : border-box;
    padding-right : 7px;
}

[data-type="control_stripe"] .form-address-table td[width="50%"] + td >span:first-child,
[data-type="control_authnet"] .form-address-table td[width="50%"] + td >span:first-child,
#creditCardTable.form-address-table td[width="50%"] + td >span:first-child {
    box-sizing : border-box;
    padding-left : 7px;
}

[data-type="control_stripe"] .form-address-table td[width="50%"] + td[width="50%"] >span:first-child,
[data-type="control_authnet"] .form-address-table td[width="50%"] + td[width="50%"] >span:first-child,
#creditCardTable.form-address-table td[width="50%"] + td[width="50%"] >span:first-child {
    box-sizing : border-box;
    padding-right : 0;
}

.hover-product-item:hover {
    color : inherit;
}

/*fix for braintree cc styling*/
[data-type="control_braintree"] .form-sub-label-container {
    width : 100% !important;
    padding : 4px;
    box-sizing : border-box;
}

[data-type="control_braintree"] .form-textbox {
    width : 100%;
}

.braintree-hosted-fields {
    width : 100% !important;
    box-sizing : border-box;
    min-height : 28px;
}

/*remove bottom spacing on CC section*/
#creditCardTable.form-address-table tbody tr + tr + tr td,
[data-type="control_stripe"] .form-address-table tbody tr + tr + tr td,
[data-type="control_authnet"] .form-address-table tbody tr + tr + tr td {
    padding-bottom : 0;
}

@media screen and (max-device-width:768px){
    .form-all {
        margin : 0 auto !important;
        width : 100% !important;
    }

    [data-type=control_fullname] .form-sub-label-container:first-child {
        margin-right : 0;
    }

}

@media screen and (max-width:480px){
    .jotform-form {
        padding : 0;
    }

    .form-input {
        width : 100% !important;
    }

    .form-label {
        width : 100% !important;
        float : none !important;
    }

    .form-line-column {
        width : 100% !important;
    }

    div.form-header-group {
        margin : 0 !important;
        padding : 24px 20px !important;
    }

    [data-type="control_datetime"] .form-sub-label-container {
        float : left;
    }

    [data-type=control_fullname] .form-sub-label-container:first-child {
        margin-right : 0;
    }

}

/*----fix the new awful error message----*/
li.form-line-error .form-error-message img {
    position: static !important;
    margin-top: 0;
    left: 0;
    top: 0;
    vertical-align: middle;
    padding: 2px 0;
}
li.form-line-error .form-error-message {
    padding: 2px 6px;
}
    /* Injected CSS Code */
</style>

<link type="text/css" rel="stylesheet" href="https://cdn02.jotfor.ms/css/styles/buttons/form-submit-button-black_blue.css?3.3.39252"/>
<form class="jotform-form" action="https://submit.jotform.com/submit/230437120236141/" method="post" name="form_230437120236141" id="230437120236141" accept-charset="utf-8" autocomplete="off"><input type="hidden" name="formID" value="230437120236141" /><input type="hidden" id="JWTContainer" value="" /><input type="hidden" id="cardinalOrderNumber" value="" />
  <div role="main" class="form-all">
    <link type="text/css" rel="stylesheet" media="all" href="https://cdn.jotfor.ms/wizards/languageWizard/custom-dropdown/css/lang-dd.css?3.3.39252" />
    <div class="cont"><input type="text" id="input_language" name="input_language" style="display:none" />
      <div class="language-dd" id="langDd" style="display:none">
        <div class="dd-placeholder lang-emp">Language</div>
        <ul class="lang-list dn" id="langList">
          <li data-lang="en" class="en">English (US)</li>
        </ul>
      </div>
    </div>
    <script type="text/javascript" src="https://cdn.jotfor.ms/js/formTranslation.v2.js?3.3.39252"></script>
    <ul class="form-section page-section">
      <li class="form-line" data-type="control_text" id="id_23">
        <div id="cid_23" class="form-input-wide">
          <div id="text_23" class="form-html" data-component="text" tabindex="0">
            <p>Bring <strong>Keynote Scott Burrows</strong> to your facility to deliver a very powerful, profound and impactful safety message that will alter people’s attitude towards safety forever! GUARANTEED!</p>
            <p>For pricing and availability please send us an email at <a href="mailto:info@charliemorecraft.com" target="_blank" rel="nofollow">info@charliemorecraft.com</a> or fill out the form below.</p>
            <p>Contact Details: +1 (561) 997-1120<br />Toll Free: (800) 783-0796<br />Email: <a href="mailto:info@charliemorecraft.com" target="_blank" rel="nofollow">info@charliemorecraft.com</a> <br />Website: <a href="https://charliemorecraft.com/on-site-presentations-with-scott-burrows-motivational-safety-speaker/" target="_blank" rel="nofollow">https://charliemorecraft.com/on-site-presentations-with-scott-burrows-motivational-safety-speaker/</a> </p>
          </div>
        </div>
      </li>
      <li class="form-line jf-required" data-type="control_textbox" id="id_20"><label class="form-label form-label-top form-label-auto" id="label_20" for="input_20"> Company<span class="form-required">*</span> </label>
        <div id="cid_20" class="form-input-wide jf-required"> <input type="text" id="input_20" name="q20_company" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="20" value="" data-component="textbox" aria-labelledby="label_20" required="" /> </div>
      </li>
      <li class="form-line jf-required" data-type="control_dropdown" id="id_26"><label class="form-label form-label-top form-label-auto" id="label_26" for="input_26"> Keynote Safety Speaker<span class="form-required">*</span> </label>
        <div id="cid_26" class="form-input-wide jf-required"> <select class="form-dropdown validate[required]" id="input_26" name="q26_keynoteSafety" style="width:150px" data-component="dropdown" required="" aria-label="Keynote Safety Speaker">
            <option value="">Please Select</option>
            <option selected="" value="Scott Burrows">Scott Burrows</option>
            <option value="Charlie Morecraft">Charlie Morecraft</option>
          </select> </div>
      </li>
      <li class="form-line form-line-column form-col-1 jf-required" data-type="control_textbox" id="id_3"><label class="form-label form-label-top" id="label_3" for="input_3"> First Name<span class="form-required">*</span> </label>
        <div id="cid_3" class="form-input-wide jf-required"> <input type="text" id="input_3" name="q3_firstName" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="23" value="" placeholder=" " data-component="textbox" aria-labelledby="label_3" required="" /> </div>
      </li>
      <li class="form-line form-line-column form-col-2 jf-required" data-type="control_textbox" id="id_9"><label class="form-label form-label-top" id="label_9" for="input_9"> Last Name<span class="form-required">*</span> </label>
        <div id="cid_9" class="form-input-wide jf-required"> <input type="text" id="input_9" name="q9_lastName" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="25" value="" placeholder=" " data-component="textbox" aria-labelledby="label_9" required="" /> </div>
      </li>
      <li class="form-line form-line-column form-col-1 form-line-column-clear jf-required" data-type="control_textbox" id="id_10"><label class="form-label form-label-top" id="label_10" for="input_10"> E-mail<span class="form-required">*</span> </label>
        <div id="cid_10" class="form-input-wide jf-required"> <input type="text" id="input_10" name="q10_email10" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="23" value="" placeholder=" " data-component="textbox" aria-labelledby="label_10" required="" /> </div>
      </li>
      <li class="form-line form-line-column form-col-2 jf-required" data-type="control_textbox" id="id_11"><label class="form-label form-label-top" id="label_11" for="input_11"> Phone<span class="form-required">*</span> </label>
        <div id="cid_11" class="form-input-wide jf-required"> <input type="text" id="input_11" name="q11_phone" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="25" value="" placeholder=" " data-component="textbox" aria-labelledby="label_11" required="" /> </div>
      </li>
      <li class="form-line jf-required" data-type="control_textarea" id="id_25"><label class="form-label form-label-top form-label-auto" id="label_25" for="input_25"> Event Date(s) and/or Location(s)<span class="form-required">*</span> </label>
        <div id="cid_25" class="form-input-wide jf-required"> <textarea id="input_25" class="form-textarea validate[required]" name="q25_eventDates" cols="40" rows="6" data-component="textarea" required="" aria-labelledby="label_25"></textarea> </div>
      </li>
      <li class="form-line" data-type="control_textarea" id="id_19"><label class="form-label form-label-top form-label-auto" id="label_19" for="input_19"> Other Details </label>
        <div id="cid_19" class="form-input-wide"> <textarea id="input_19" class="form-textarea" name="q19_otherDetails" cols="70" rows="6" data-component="textarea" aria-labelledby="label_19"></textarea> </div>
      </li>
      <li class="form-line jf-required" data-type="control_captcha" id="id_21"><label class="form-label form-label-top form-label-auto" id="label_21" for="input_21"> Please verify that you are human<span class="form-required">*</span> </label>
        <div id="cid_21" class="form-input-wide jf-required">
          <section data-wrapper-react="true">
            <div id="recaptcha_input_21" data-component="recaptcha" data-callback="recaptchaCallbackinput_21" data-expired-callback="recaptchaExpiredCallbackinput_21"></div><input type="hidden" id="input_21" class="hidden validate[required]" name="recaptcha_visible" required="" />
            <script type="text/javascript" src="https://www.google.com/recaptcha/api.js?render=explicit&amp;onload=recaptchaLoadedinput_21"></script>
            <script type="text/javascript">
              var recaptchaLoadedinput_21 = function()
              {
                window.grecaptcha.render($("recaptcha_input_21"),
                {
                  sitekey: '6LdU3CgUAAAAAB0nnFM3M3T0sy707slYYU51RroJ',
                });
                var grecaptchaBadge = document.querySelector('.grecaptcha-badge');
                if (grecaptchaBadge)
                {
                  grecaptchaBadge.style.boxShadow = 'gray 0px 0px 2px';
                }
              };

              /**
               * Called when the reCaptcha verifies the user is human
               * For invisible reCaptcha;
               *   Submit event is stopped after validations and recaptcha is executed.
               *   If a challenge is not displayed, this will be called right after grecaptcha.execute()
               *   If a challenge is displayed, this will be called when the challenge is solved successfully
               *   Submit is triggered to actually submit the form since it is stopped before.
               */
              var recaptchaCallbackinput_21 = function()
              {
                var isInvisibleReCaptcha = false;
                var hiddenInput = $("input_21");
                hiddenInput.setValue(1);
                if (!isInvisibleReCaptcha)
                {
                  if (hiddenInput.validateInput)
                  {
                    hiddenInput.validateInput();
                  }
                }
                else
                {
                  triggerSubmit(hiddenInput.form)
                }

                function triggerSubmit(formElement)
                {
                  var button = formElement.ownerDocument.createElement('input');
                  button.style.display = 'none';
                  button.type = 'submit';
                  formElement.appendChild(button).click();
                  formElement.removeChild(button);
                }
              }

              // not really required for invisible recaptcha
              var recaptchaExpiredCallbackinput_21 = function()
              {
                var hiddenInput = $("input_21");
                hiddenInput.writeAttribute("value", false);
                if (hiddenInput.validateInput)
                {
                  hiddenInput.validateInput();
                }
              }
            </script>
          </section>
        </div>
      </li>
      <li class="form-line" data-type="control_button" id="id_8">
        <div id="cid_8" class="form-input-wide">
          <div data-align="center" class="form-buttons-wrapper form-buttons-center   jsTest-button-wrapperField"><button id="input_8" type="submit" class="form-submit-button form-submit-button-black_blue submit-button jf-form-buttons jsTest-submitField" data-component="button" data-content="">Submit</button></div>
        </div>
      </li>
      <li style="display:none">Should be Empty: <input type="text" name="website" value="" /></li>
    </ul>
  </div>
  <script>
    JotForm.showJotFormPowered = "0";
  </script>
  <script>
    JotForm.poweredByText = "Powered by Jotform";
  </script><input type="hidden" class="simple_spc" id="simple_spc" name="simple_spc" value="230437120236141" />
  <script type="text/javascript">
    var all_spc = document.querySelectorAll("form[id='230437120236141'] .si" + "mple" + "_spc");
    for (var i = 0; i < all_spc.length; i++)
    {
      all_spc[i].value = "230437120236141-230437120236141";
    }
  </script>
</form><script type="text/javascript">JotForm.ownerView=true;</script>
<p>The post <a href="https://www.charlieonsafety.com/safety-presentations-with-motivational-safety-speaker-scott-burrows/">Safety Presentations with Motivational Safety Speaker Scott Burrows</a> appeared first on <a href="https://www.charlieonsafety.com">Charlie Morecraft</a>.</p>
]]></content:encoded>
					
		
		
			</item>
		<item>
		<title>Charlie Morecraft – Motivational Safety Speaker and Safety Coach</title>
		<link>https://www.charlieonsafety.com/charlie-morecraft-motivational-safety-speaker-and-safety-coach/</link>
		
		<dc:creator><![CDATA[Charlie Morecraft]]></dc:creator>
		<pubDate>Wed, 14 Jul 2021 13:27:54 +0000</pubDate>
				<category><![CDATA[safety coach]]></category>
		<category><![CDATA[Safety Stand-Down]]></category>
		<category><![CDATA[Speaker's Team]]></category>
		<category><![CDATA[Speaker's team]]></category>
		<guid isPermaLink="false">https://www.charlieonsafety.com/?p=2389</guid>

					<description><![CDATA[<p>Charlie Morecraft, an ordinary guy with an extraordinary story! Charlie had more than 15 years experience on the job, and he knew it well. He knew all the rules. He knew all the safety regulations . . . and he knew all the shortcuts around them too. Yes, Charlie was just like all the other &#8230; </p>
<p>The post <a href="https://www.charlieonsafety.com/charlie-morecraft-motivational-safety-speaker-and-safety-coach/">Charlie Morecraft – Motivational Safety Speaker and Safety Coach</a> appeared first on <a href="https://www.charlieonsafety.com">Charlie Morecraft</a>.</p>
]]></description>
										<content:encoded><![CDATA[<h3 data-uw-styling-context="true">Charlie Morecraft, an ordinary guy with an extraordinary story!</h3>
<p data-uw-styling-context="true">Charlie had more than 15 years experience on the job, and he knew it well. He knew all the rules. He knew all the safety regulations . . . and he knew all the shortcuts around them too. Yes, Charlie was just like all the other seasoned workers at the refinery; he was certain that nothing could go wrong when he was in control. And he was right ….. Except for this one time . . .</p>
<p data-uw-styling-context="true">When Charlie tells his story the audience sits in rapt attention as they are moved to new levels of awareness. Charlie has that rare and unique ability to speak with ordinary words and conjure extraordinary images. Both he and his story are unforgettable. His words are simple, and he tells us things we think we already know, but he tells it in a way that will dramatically change our attitudes toward safety forever.</p>
<h3 data-uw-styling-context="true">Anyone who hears Charlie’s story will be deeply moved and motivated to never again take safety for granted.</h3>
<p data-uw-styling-context="true">Charlie’s emphasis is on the significance of attitude and personal responsibility.</p>
<p><strong data-uw-styling-context="true">Some of the learning objectives are:</strong></p>
<p data-uw-styling-context="true">(1) To facilitate insight into everyone’s own safety practices and attitudes</p>
<p data-uw-styling-context="true">(2) To be a “wake-up call” that shakes people out of complacency and taking responsibilities for granted</p>
<p data-uw-styling-context="true">(3) To make people become more responsible for their own safety on the job, at home, at play, at travel, everywhere.  This continues to result in people handling all aspects of their lives with a greater awareness and appreciation of safety.  Some examples are; wearing prescribed safety equipment on the job, following safety procedures at work and at home, wearing seat belts in moving vehicles, etc.</p>
<h3 data-uw-styling-context="true">His primary messages are “Safety is about going home at the end of the day, kissing your wife and hugging your kids”, and “We are each responsible for our own safety”.</h3>
<p>Having been critically injured in an explosion that burned over 45% of his body, Charlie Morecraft conveys, in the most penetrating way, the lesson he so painfully learned.  Seldom, are people confronted by the real consequences of an abuse in safety practices.</p>
<p data-uw-styling-context="true">They aren’t new messages, but Charlie gives us a powerful new way of looking at them.</p>
<p data-uw-styling-context="true">Charlie Morecraft is an ordinary guy with an extraordinary story that <strong data-uw-styling-context="true">Saves Lives!</strong></p>
<p data-uw-styling-context="true">Most people have the same attitude about safety that Charlie Morecraft had for a decade and a half while working at a refinery.</p>
<h3 data-uw-styling-context="true">Charlie’s message alters people’s attitudes toward safety, their consciousness is raised to a new level.</h3>
<p data-uw-styling-context="true">Their actions and behavior go from being thoughtless, lackadaisical and routine to “safety first &amp; always”.</p>
<p data-uw-styling-context="true">Charlie Morecraft is a powerful and dynamic public speaker.  His audiences get a highly personal, private look at what happened to one man – – – and how it could happen to any one of us.  As Charlie always says – “I’m just an ordinary guy…with an extraordinary story to tell”.</p>
<p><strong data-uw-styling-context="true"><a href="https://www.charlieonsafety.com/on-site-safety-presentations/">On-Site Safety Presentations</a> &amp; <a href="https://www.charlieonsafety.com/safety-live-webinars/">Streaming &amp; Live Safety Webinars</a></strong></p>
<p data-uw-styling-context="true">These safety presentations typically runs 1 hour followed by a 15-30 minute question and answer session where Charlie interacts with the audience.</p>
<p data-uw-styling-context="true">Please feel free to ask about discounts for multiple presentations. Charlie has a second presentation called “<a href="https://www.charlieonsafety.com/product/safety-everyones-responsibility-video/" data-uw-styling-context="true">Safety’s Everyone’s Responsibility</a>” that can be used as a follow-up to “Remember Charlie” or stand on its own.</p>
<p data-uw-styling-context="true"><a href="https://www.charlieonsafety.com/safety-live-webinars/"><img decoding="async" class="alignnone wp-image-2220" src="https://www.charlieonsafety.com/wp-content/uploads/2021/06/custom-recordings.jpg" alt="" width="279" height="174" srcset="https://www.charlieonsafety.com/wp-content/uploads/2021/06/custom-recordings.jpg 804w, https://www.charlieonsafety.com/wp-content/uploads/2021/06/custom-recordings-300x187.jpg 300w, https://www.charlieonsafety.com/wp-content/uploads/2021/06/custom-recordings-768x479.jpg 768w, https://www.charlieonsafety.com/wp-content/uploads/2021/06/custom-recordings-96x60.jpg 96w, https://www.charlieonsafety.com/wp-content/uploads/2021/06/custom-recordings-600x374.jpg 600w" sizes="(max-width: 279px) 100vw, 279px" /></a></p>
<p><strong data-uw-styling-context="true">Endorsements</strong></p>
<p data-uw-styling-context="true">Read some of the endorsements Charlie has received, and magazine articles published throughout the years at <a href="https://www.charliemorecraft.com/category/speaker-endorsements/" data-uw-styling-context="true">https://www.charliemorecraft.com/category/speaker-endorsements/</a></p>
<p data-uw-styling-context="true">For testimonials visit <a href="https://www.charliemorecraft.com/testimonials/" data-uw-styling-context="true">https://www.charliemorecraft.com/testimonials/</a></p>
<p><strong data-uw-styling-context="true">List of Clients</strong></p>
<p data-uw-styling-context="true">Charlie has became a safety expert whose clients number more than <strong data-uw-styling-context="true">25,000+ companies worldwide</strong>. His inspiring story has already helped hundreds of thousands to put on their helmets, their safety goggles, and use their common sense before tackling any job or potentially dangerous activity. Check a partial list of clients at <a href="https://www.charliemorecraft.com/clients/" data-uw-styling-context="true">https://www.charliemorecraft.com/clients/</a></p>
<p><strong data-uw-styling-context="true">Safety Videos from Charlie Morecraft</strong></p>
<p data-uw-styling-context="true">Charlie’s motivational safety videos, including the best seller “<a href="https://www.charlieonsafety.com/product/remember-charlie-best-seller-safety-video/" data-uw-styling-context="true">Remember Charlie</a>”, have been seen by millions worldwide. Suitable for any company looking to drop accident-ratio, these videos are powerful, profound and impactful, often altering people’s attitude towards safety forever. Buy videos at <a href="https://www.charlieonsafety.com/product-category/safety-videos/">https://www.charlieonsafety.com/product-category/safety-videos/</a></p>
<p data-uw-styling-context="true">Thank you and Stay Safe!<br />
– <em data-uw-styling-context="true">Charlie Morecraft</em></p>
<p data-uw-styling-context="true">If you need any additional information on bringing Charlie to your facility please contact us at 1 800-783-0796 OR 561-997-1120, by email at <a href="mailto:info@charliemorecraft.com" data-uw-styling-context="true">info@charliemorecraft.com</a> or fill out the request form below.</p>
<p data-uw-styling-context="true"><strong data-uw-styling-context="true">Booking Request</strong></p>
<p data-uw-styling-context="true"><script src="https://cdn03.jotfor.ms/static/prototype.forms.js?3.3.39251" type="text/javascript"></script>
<script src="https://cdn01.jotfor.ms/static/jotform.forms.js?3.3.39251" type="text/javascript"></script>
<script type="text/javascript">	JotForm.newDefaultTheme = false;
	JotForm.extendsNewTheme = false;
	JotForm.singleProduct = false;
	JotForm.newPaymentUIForNewCreatedForms = false;
	JotForm.highlightInputs = false;

	JotForm.init(function(){
	/*INIT-START*/
if (window.JotForm && JotForm.accessible) $('input_20').setAttribute('tabindex',0);
if (window.JotForm && JotForm.accessible) $('input_3').setAttribute('tabindex',0);
if (window.JotForm && JotForm.accessible) $('input_9').setAttribute('tabindex',0);
if (window.JotForm && JotForm.accessible) $('input_10').setAttribute('tabindex',0);
if (window.JotForm && JotForm.accessible) $('input_11').setAttribute('tabindex',0);
if (window.JotForm && JotForm.accessible) $('input_25').setAttribute('tabindex',0);
if (window.JotForm && JotForm.accessible) $('input_19').setAttribute('tabindex',0);
      JotForm.alterTexts({"ageVerificationError":"You must be older than {minAge} years old to submit this form.","alphabetic":"This field can only contain letters","alphanumeric":"This field can only contain letters and numbers.","appointmentSelected":"You’ve selected {time} on {date}","ccDonationMinLimitError":"Minimum amount is {minAmount} {currency}","ccInvalidCVC":"CVC number is invalid.","ccInvalidExpireDate":"Expire date is invalid.","ccInvalidExpireMonth":"Expiration month is invalid.","ccInvalidExpireYear":"Expiration year is invalid.","ccInvalidNumber":"Credit Card Number is invalid.","ccMissingDetails":"Please fill up the credit card details.","ccMissingDonation":"Please enter numeric values for donation amount.","ccMissingProduct":"Please select at least one product.","characterLimitError":"Too many Characters.  The limit is","characterMinLimitError":"Too few characters. The minimum is","confirmClearForm":"Are you sure you want to clear the form","confirmEmail":"E-mail does not match","currency":"This field can only contain currency values.","cyrillic":"This field can only contain cyrillic characters","dateInvalid":"This date is not valid. The date format is {format}","dateInvalidSeparate":"This date is not valid. Enter a valid {element}.","dateLimited":"This date is unavailable.","disallowDecimals":"Please enter a whole number.","doneButton":"Done","doneMessage":"Well done! All errors are fixed.","dragAndDropFilesHere_infoMessage":"Drag and drop files here","email":"Enter a valid e-mail address","fillMask":"Field value must fill mask.","freeEmailError":"Free email accounts are not allowed","generalError":"There are errors on the form. Please fix them before continuing.","generalPageError":"There are errors on this page. Please fix them before continuing.","geoNotAvailableDesc":"Location provider not available. Please enter the address manually.","geoNotAvailableTitle":"Position Unavailable","geoPermissionDesc":"Check your browser's privacy settings.","geoPermissionTitle":"Permission Denied","geoTimeoutDesc":"Please check your internet connection and try again.","geoTimeoutTitle":"Timeout","gradingScoreError":"Score total should only be less than or equal to","incompleteFields":"There are incomplete required fields. Please complete them.","inputCarretErrorA":"Input should not be less than the minimum value:","inputCarretErrorB":"Input should not be greater than the maximum value:","justSoldOut":"Just Sold Out","lessThan":"Your score should be less than or equal to","maxDigitsError":"The maximum digits allowed is","maxFileSize_infoMessage":"Max. file size","maxSelectionsError":"The maximum number of selections allowed is ","minCharactersError":"The number of characters should not be less than the minimum value:","minSelectionsError":"The minimum required number of selections is ","multipleError":"There are {count} errors in this page. Please correct them before moving on.","multipleFileUploads_emptyError":"{file} is empty, please select files again without it.","multipleFileUploads_fileLimitError":"Only {fileLimit} file uploads allowed.","multipleFileUploads_minSizeError":"{file} is too small, minimum file size is {minSizeLimit}.","multipleFileUploads_onLeave":"The files are being uploaded, if you leave now the upload will be cancelled.","multipleFileUploads_sizeError":"{file} is too large, maximum file size is {sizeLimit}.","multipleFileUploads_typeError":"{file} has invalid extension. Only {extensions} are allowed.","multipleFileUploads_uploadFailed":"File upload failed, please remove it and upload the file again.","noSlotsAvailable":"No slots available","notEnoughStock":"Not enough stock for the current selection","notEnoughStock_remainedItems":"Not enough stock for the current selection ({count} items left)","noUploadExtensions":"File has no extension file type (e.g. .txt, .png, .jpeg)","numeric":"This field can only contain numeric values","oneError":"There is {count} error in this page. Please correct it before moving on.","pastDatesDisallowed":"Date must not be in the past.","pleaseWait":"Please wait...","required":"This field is required.","requiredLegend":"All fields marked with * are required and must be filled.","requireEveryCell":"Every cell is required.","requireEveryRow":"Every row is required.","requireOne":"At least one field required.","restrictedDomain":"This domain is not allowed","seeErrorsButton":"See Errors","selectionSoldOut":"Selection Sold Out","slotUnavailable":"{time} on {date} has been selected is unavailable. Please select another slot.","soldOut":"Sold Out","subProductItemsLeft":"({count} items left)","uploadExtensions":"You can only upload following files:","uploadFilesize":"File size cannot be bigger than:","uploadFilesizemin":"File size cannot be smaller than:","url":"This field can only contain a valid URL","validateEmail":"You need to validate this e-mail","wordLimitError":"Too many words. The limit is","wordMinLimitError":"Too few words.  The minimum is"});
      FormTranslation.init({"detectUserLanguage":"1","firstPageOnly":"0","options":"English (US)","originalLanguage":"en","primaryLanguage":"en","saveUserLanguage":"1","showStatus":"flag-with-nation","theme":"light-theme","version":"2"});
	/*INIT-END*/
	});

   JotForm.prepareCalculationsOnTheFly([null,null,null,{"name":"firstName","qid":"3","text":"First Name","type":"control_textbox"},null,null,null,null,{"name":"submit","qid":"8","text":"Submit","type":"control_button"},{"name":"lastName","qid":"9","text":"Last Name","type":"control_textbox"},{"name":"email10","qid":"10","text":"E-mail","type":"control_textbox"},{"name":"phone","qid":"11","text":"Phone","type":"control_textbox"},null,null,null,null,null,null,null,{"name":"message","qid":"19","text":"Message","type":"control_textarea"},{"description":"","name":"company","qid":"20","subLabel":"","text":"Company","type":"control_textbox"},{"description":"","name":"pleaseVerify","qid":"21","text":"Please verify that you are human","type":"control_captcha"},null,{"name":"input23","qid":"23","text":"Bring Keynote Safety Speaker Charlie Morecraft to your facility to deliver a very powerful, profound and impactful safety message that will alter people’s attitude towards safety forever! GUARANTEED!\nFor pricing and availability please send us an email at info@charliemorecraft.com or fill out the form below.\nContact Details: +1 (561) 997-1120 Toll Free: (800) 783-0796Email: info@charliemorecraft.com Website: https:\u002F\u002Fcharliemorecraft.com\u002Fmotivational-safety-presentations\u002F","type":"control_text"},null,{"description":"","name":"eventDates","qid":"25","subLabel":"","text":"Event Date(s) and\u002For Location(s)","type":"control_textarea"}]);
   setTimeout(function() {
JotForm.paymentExtrasOnTheFly([null,null,null,{"name":"firstName","qid":"3","text":"First Name","type":"control_textbox"},null,null,null,null,{"name":"submit","qid":"8","text":"Submit","type":"control_button"},{"name":"lastName","qid":"9","text":"Last Name","type":"control_textbox"},{"name":"email10","qid":"10","text":"E-mail","type":"control_textbox"},{"name":"phone","qid":"11","text":"Phone","type":"control_textbox"},null,null,null,null,null,null,null,{"name":"message","qid":"19","text":"Message","type":"control_textarea"},{"description":"","name":"company","qid":"20","subLabel":"","text":"Company","type":"control_textbox"},{"description":"","name":"pleaseVerify","qid":"21","text":"Please verify that you are human","type":"control_captcha"},null,{"name":"input23","qid":"23","text":"Bring Keynote Safety Speaker Charlie Morecraft to your facility to deliver a very powerful, profound and impactful safety message that will alter people’s attitude towards safety forever! GUARANTEED!\nFor pricing and availability please send us an email at info@charliemorecraft.com or fill out the form below.\nContact Details: +1 (561) 997-1120 Toll Free: (800) 783-0796Email: info@charliemorecraft.com Website: https:\u002F\u002Fcharliemorecraft.com\u002Fmotivational-safety-presentations\u002F","type":"control_text"},null,{"description":"","name":"eventDates","qid":"25","subLabel":"","text":"Event Date(s) and\u002For Location(s)","type":"control_textarea"}]);}, 20); 
</script>
<link href="https://cdn01.jotfor.ms/static/formCss.css?3.3.39251" rel="stylesheet" type="text/css" />
<style type="text/css">@media print{.form-section{display:inline!important}.form-pagebreak{display:none!important}.form-section-closed{height:auto!important}.page-section{position:initial!important}}</style>
<link type="text/css" rel="stylesheet" href="https://cdn02.jotfor.ms/css/styles/nova.css?3.3.39251" />
<link type="text/css" rel="stylesheet" href="https://cdn03.jotfor.ms/themes/CSS/566a91c2977cdfcd478b4567.css?themeRevisionID=58c6459d9a11c7136a8b4567"/>
<link type="text/css" rel="stylesheet" href="https://cdn01.jotfor.ms/css/styles/payment/payment_feature.css?3.3.39251" />
<style type="text/css">


    .form-label-left{
        width:150px;
    }
    .form-line{
        padding-top:5px;
        padding-bottom:5px;
    }
    .form-label-right{
        width:150px;
    }
    .form-all{
        width:480px;
        color:#555 !important;
        font-family:'Roboto';
        font-size:14px;
    }
    .form-radio-item label, .form-checkbox-item label, .form-grading-label, .form-header{
        color: #0D0D0D;
    }

</style>

<style type="text/css" id="form-designer-style">
@import "https://fonts.googleapis.com/css?family=Roboto:light,lightitalic,normal,italic,bold,bolditalic";
@import (css) "@{buttonFontLink}";
    /* Injected CSS Code */

.form-all {
  font-family: "Roboto", sans-serif;
}
.form-all {
  width: 480px;
}
.form-label-left,
.form-label-right {
  width: 150px;
}
.form-label {
  white-space: normal;
}
.form-label.form-label-auto {
  display: block;
  float: none;
  text-align: left;
}
.form-label-left {
  display: inline-block;
  white-space: normal;
  float: left;
  text-align: left;
}
.form-label-right {
  display: inline-block;
  white-space: normal;
  float: left;
  text-align: right;
}
.form-label-top {
  white-space: normal;
  display: block;
  float: none;
  text-align: left;
}
.form-radio-item label:before {
  top: 0;
}
.form-all {
  font-size: 14px;
}
.form-label {
  font-weight: normal;
  font-size: 0.95em;
}
.supernova {
  background-color: #ffffff;
}
.supernova body {
  background-color: transparent;
}
/*
@width30: (unit(@formWidth, px) + 60px);
@width60: (unit(@formWidth, px)+ 120px);
@width90: (unit(@formWidth, px)+ 180px);
*/
/* | */
@media screen and (min-width: 480px) {
  .supernova .form-all {
    border: 1px solid #e6e6e6;
    -webkit-box-shadow: 0 3px 9px rgba(0, 0, 0, 0.1);
    -moz-box-shadow: 0 3px 9px rgba(0, 0, 0, 0.1);
    box-shadow: 0 3px 9px rgba(0, 0, 0, 0.1);
  }
}
/* | */
/* | */
@media screen and (max-width: 480px) {
  .jotform-form {
    padding: 10px 0;
  }
}
/* | */
/* | */
@media screen and (min-width: 480px) and (max-width: 768px) {
  .jotform-form {
    padding: 30px 0;
  }
}
/* | */
/* | */
@media screen and (min-width: 480px) and (max-width: 479px) {
  .jotform-form {
    padding: 30px 0;
  }
}
/* | */
/* | */
@media screen and (min-width: 768px) {
  .jotform-form {
    padding: 60px 0;
  }
}
/* | */
/* | */
@media screen and (max-width: 479px) {
  .jotform-form {
    padding: 12px;
  }
}
/* | */
.supernova .form-all,
.form-all {
  background-color: #ffffff;
  border: 1px solid transparent;
}
.form-header-group {
  border-color: #e6e6e6;
}
.form-matrix-table tr {
  border-color: #e6e6e6;
}
.form-matrix-table tr:nth-child(2n) {
  background-color: #f2f2f2;
}
.form-all {
  color: #555555;
}
.form-header-group .form-header {
  color: #555555;
}
.form-header-group .form-subHeader {
  color: #6f6f6f;
}
.form-sub-label {
  color: #6f6f6f;
}
.form-label-top,
.form-label-left,
.form-label-right,
.form-html {
  color: #6f6f6f;
}
.form-checkbox-item label,
.form-radio-item label {
  color: #555555;
}
.form-line.form-line-active {
  -webkit-transition-property: all;
  -moz-transition-property: all;
  -ms-transition-property: all;
  -o-transition-property: all;
  transition-property: all;
  -webkit-transition-duration: 0.3s;
  -moz-transition-duration: 0.3s;
  -ms-transition-duration: 0.3s;
  -o-transition-duration: 0.3s;
  transition-duration: 0.3s;
  -webkit-transition-timing-function: ease;
  -moz-transition-timing-function: ease;
  -ms-transition-timing-function: ease;
  -o-transition-timing-function: ease;
  transition-timing-function: ease;
  background-color: rgba(255, 255, 224, 0);
}
/* omer */
.form-radio-item,
.form-checkbox-item {
  padding-bottom: 0px !important;
}
.form-radio-item:last-child,
.form-checkbox-item:last-child {
  padding-bottom: 0;
}
/* omer */
.form-single-column .form-checkbox-item,
.form-single-column .form-radio-item {
  width: 100%;
}
.supernova {
  height: 100%;
  background-repeat: no-repeat;
  background-attachment: scroll;
  background-position: center top;
  background-repeat: repeat;
}
.supernova {
  background-image: none;
}
#stage {
  background-image: none;
}
/* | */
.form-all {
  background-repeat: no-repeat;
  background-attachment: scroll;
  background-position: center top;
  background-repeat: repeat;
}
.form-header-group {
  background-repeat: no-repeat;
  background-attachment: scroll;
  background-position: center top;
}
.form-line {
  margin-top: 0px;
  margin-bottom: 0px;
}
.form-line {
  padding: 8px 36px;
}
.form-all .form-textbox,
.form-all .form-radio-other-input,
.form-all .form-checkbox-other-input,
.form-all .form-captcha input,
.form-all .form-spinner input,
.form-all .form-pagebreak-back,
.form-all .form-pagebreak-next,
.form-all .qq-upload-button,
.form-all .form-error-message {
  -webkit-border-radius: 6px;
  -moz-border-radius: 6px;
  border-radius: 6px;
}
.form-all .form-sub-label {
  margin-left: 3px;
}
.form-all .form-textarea {
  -webkit-border-radius: 6px;
  -moz-border-radius: 6px;
  border-radius: 6px;
}
.form-all {
  -webkit-border-radius: 6px;
  -moz-border-radius: 6px;
  border-radius: 6px;
}
.form-section:first-child {
  -webkit-border-radius: 6px 6px 0 0;
  -moz-border-radius: 6px 6px 0 0;
  border-radius: 6px 6px 0 0;
}
.form-section:last-child {
  -webkit-border-radius: 0 0 6px 6px;
  -moz-border-radius: 0 0 6px 6px;
  border-radius: 0 0 6px 6px;
}
.form-all .qq-upload-button,
.form-all .form-submit-button,
.form-all .form-submit-reset,
.form-all .form-submit-print {
  font-size: 1em;
  padding: 9px 15px;
  font-family: "Roboto", sans-serif;
  font-size: 14px;
  font-weight: normal;
}
.form-all .form-pagebreak-back,
.form-all .form-pagebreak-next {
  font-size: 1em;
  padding: 9px 15px;
  font-family: "Roboto", sans-serif;
  font-size: 14px;
  font-weight: normal;
}
/*
& when ( @buttonFontType = google ) {
	
}
*/
h2.form-header {
  line-height: 1.618em;
  font-size: 1.714em;
}
h2 ~ .form-subHeader {
  line-height: 1.5em;
  font-size: 1.071em;
}
.form-header-group {
  text-align: left;
}
/*.form-dropdown,
.form-radio-item,
.form-checkbox-item,
.form-radio-other-input,
.form-checkbox-other-input,*/
.form-captcha input,
.form-spinner input,
.form-error-message {
  padding: 4px 3px 2px 3px;
}
.form-header-group {
  font-family: "Roboto", sans-serif;
}
.form-section {
  padding: 0px 0px 0px 0px;
}
.form-header-group {
  margin: 0px 0px 0px 0px;
}
.form-header-group {
  padding: 12px 36px 12px 36px;
}
.form-header-group {
  background-color: #f5f5f5;
}
.form-textbox,
.form-textarea {
  padding: 4px 3px 2px 3px;
}
.form-textbox,
.form-textarea,
.form-radio-other-input,
.form-checkbox-other-input,
.form-captcha input,
.form-spinner input {
  background-color: #ffffff;
}
[data-type="control_dropdown"] .form-input,
[data-type="control_dropdown"] .form-input-wide {
  width: 150px;
}
.form-label {
  font-family: "Roboto", sans-serif;
}
li[data-type="control_image"] div {
  text-align: left;
}
li[data-type="control_image"] img {
  border: none;
  border-width: 0px !important;
  border-style: solid !important;
  border-color: false !important;
}
.form-line-column {
  width: auto;
}
.form-line-error {
  background-color: #ffffff;
  -webkit-box-shadow: inset 0px 3px 11px -7px #ff3200;
  -moz-box-shadow: inset 0px 3px 11px -7px #ff3200;
  box-shadow: inset 0px 3px 11px -7px #ff3200;
}
.form-line-error input:not(#coupon-input),
.form-line-error textarea,
.form-line-error .form-validation-error {
  -webkit-transition-property: none;
  -moz-transition-property: none;
  -ms-transition-property: none;
  -o-transition-property: none;
  transition-property: none;
  -webkit-transition-duration: 0.3s;
  -moz-transition-duration: 0.3s;
  -ms-transition-duration: 0.3s;
  -o-transition-duration: 0.3s;
  transition-duration: 0.3s;
  -webkit-transition-timing-function: ease;
  -moz-transition-timing-function: ease;
  -ms-transition-timing-function: ease;
  -o-transition-timing-function: ease;
  transition-timing-function: ease;
  border: 1px solid #fff4f4;
  -moz-box-shadow: 0 0 3px #fff4f4;
  -webkit-box-shadow: 0 0 3px #fff4f4;
  box-shadow: 0 0 3px #fff4f4;
}
.form-line-error .form-error-message {
  margin: 0;
  position: absolute;
  color: #fff;
  display: inline-block;
  right: 0;
  font-size: 10px;
  position: absolute!important;
  box-shadow: none;
  top: 0px;
  line-height: 20px;
  color: #FFF;
  background: #ff3200;
  padding: 0px 5px;
  bottom: auto;
  min-width: 105px;
  -webkit-border-radius: 0;
  -moz-border-radius: 0;
  border-radius: 0;
}
.form-line-error .form-error-message img,
.form-line-error .form-error-message .form-error-arrow {
  display: none;
}
.ie-8 .form-all {
  margin-top: auto;
  margin-top: initial;
}
.ie-8 .form-all:before {
  display: none;
}
/* | */
@media screen and (max-width: 480px), screen and (max-device-width: 768px) and (orientation: portrait), screen and (max-device-width: 415px) and (orientation: landscape) {
  .testOne {
    letter-spacing: 0;
  }
  .jotform-form {
    padding: 12px 0 0 0;
  }
  .form-all {
    border: 0;
    width: 94%!important;
    max-width: initial;
  }
  .form-sub-label-container {
    width: 100%;
    margin: 0;
    margin-right: 0;
    float: left;
    -moz-box-sizing: border-box;
    -webkit-box-sizing: border-box;
    box-sizing: border-box;
  }
  span.form-sub-label-container + span.form-sub-label-container {
    margin-right: 0;
  }
  .form-sub-label {
    white-space: normal;
  }
  .form-address-table td,
  .form-address-table th {
    padding: 0 1px 10px;
  }
  .form-submit-button,
  .form-submit-print,
  .form-submit-reset {
    width: 100%;
    margin-left: 0!important;
  }
  div[id*=at_] {
    font-size: 14px;
    font-weight: 700;
    height: 8px;
    margin-top: 6px;
  }
  .showAutoCalendar {
    width: 20px;
  }
  img.form-image {
    max-width: 100%;
    height: auto;
  }
  .form-matrix-row-headers {
    width: 100%;
    word-break: break-all;
    min-width: 40px;
  }
  .form-collapse-table,
  .form-header-group {
    margin: 0;
  }
  .form-collapse-table {
    height: 100%;
    display: inline-block;
    width: 100%;
  }
  .form-collapse-hidden {
    display: none !important;
  }
  .form-input {
    width: 100%;
  }
  .form-label {
    width: 100% !important;
  }
  .form-label-left,
  .form-label-right {
    display: block;
    float: none;
    text-align: left;
    width: auto!important;
  }
  .form-line,
  .form-line.form-line-column {
    padding: 2% 5%;
    -moz-box-sizing: border-box;
    -webkit-box-sizing: border-box;
    box-sizing: border-box;
  }
  input[type=text],
  input[type=email],
  input[type=tel],
  textarea {
    width: 100%;
    -moz-box-sizing: border-box;
    -webkit-box-sizing: border-box;
    box-sizing: border-box;
    max-width: initial !important;
  }
  .form-dropdown,
  .form-textarea,
  .form-textbox {
    width: 100%!important;
    -moz-box-sizing: border-box;
    -webkit-box-sizing: border-box;
    box-sizing: border-box;
  }
  .form-input,
  .form-input-wide,
  .form-textarea,
  .form-textbox,
  .form-dropdown {
    max-width: initial!important;
  }
  .form-address-city,
  .form-address-line,
  .form-address-postal,
  .form-address-state,
  .form-address-table,
  .form-address-table .form-sub-label-container,
  .form-address-table select,
  .form-input {
    width: 100%;
  }
  div.form-header-group {
    padding: 12px 36px !important;
    padding-left: 5%!important;
    padding-right: 5%!important;
    margin: 0 0px 2% !important;
    -moz-box-sizing: border-box;
    -webkit-box-sizing: border-box;
    box-sizing: border-box;
  }
  div.form-header-group.hasImage img {
    max-width: 100%;
  }
  [data-type="control_button"] {
    margin-bottom: 0 !important;
  }
  [data-type=control_fullname] .form-sub-label-container {
    width: 48%;
  }
  [data-type=control_fullname] .form-sub-label-container:first-child {
    margin-right: 4%;
  }
  [data-type=control_phone] .form-sub-label-container {
    width: 65%;
  }
  [data-type=control_phone] .form-sub-label-container:first-child {
    width: 31%;
    margin-right: 4%;
  }
  [data-type=control_datetime] .form-sub-label-container + .form-sub-label-container,
  [data-type=control_datetime] .form-sub-label-container:first-child {
    width: 27.3%;
    margin-right: 6%;
  }
  [data-type=control_datetime] .form-sub-label-container + .form-sub-label-container + .form-sub-label-container {
    width: 33.3%;
    margin-right: 0;
  }
  [data-type=control_datetime] span + span + span > span:first-child {
    display: block;
    width: 100% !important;
  }
  [data-type=control_birthdate] .form-sub-label-container,
  [data-type=control_datetime] span + span + span > span:first-child + span + span,
  [data-type=control_time] .form-sub-label-container {
    width: 27.3%!important;
    margin-right: 6% !important;
  }
  [data-type=control_birthdate] .form-sub-label-container:last-child,
  [data-type=control_time] .form-sub-label-container:last-child {
    width: 33.3%!important;
    margin-right: 0 !important;
  }
  .form-pagebreak-back-container,
  .form-pagebreak-next-container {
    width: 50% !important;
  }
  .form-pagebreak-back,
  .form-pagebreak-next,
  .form-product-item.hover-product-item {
    width: 100%;
  }
  .form-pagebreak-back-container {
    padding: 0;
    text-align: right;
  }
  .form-pagebreak-next-container {
    padding: 0;
    text-align: left;
  }
  .form-pagebreak {
    margin: 0 auto;
  }
  .form-buttons-wrapper {
    margin: 0!important;
    margin-left: 0!important;
  }
  .form-buttons-wrapper button {
    width: 100%;
  }
  .form-buttons-wrapper .form-submit-print {
    margin: 0 !important;
  }
  table {
    width: 100%!important;
    max-width: initial!important;
  }
  table td + td {
    padding-left: 3%;
  }
  .form-checkbox-item,
  .form-radio-item {
    white-space: normal!important;
  }
  .form-checkbox-item input,
  .form-radio-item input {
    width: auto;
  }
  .form-collapse-table {
    margin: 0 5%;
    display: block;
    zoom: 1;
    width: auto;
  }
  .form-collapse-table:before,
  .form-collapse-table:after {
    display: table;
    content: '';
    line-height: 0;
  }
  .form-collapse-table:after {
    clear: both;
  }
  .fb-like-box {
    width: 98% !important;
  }
  .form-error-message {
    clear: both;
    bottom: -10px;
  }
  .date-separate,
  .phone-separate {
    display: none;
  }
  .custom-field-frame,
  .direct-embed-widgets,
  .signature-pad-wrapper {
    width: 100% !important;
  }
}
/* | */

/*PREFERENCES STYLE*/
    .form-all {
      font-family: Roboto, sans-serif;
    }
    .form-all .qq-upload-button,
    .form-all .form-submit-button,
    .form-all .form-submit-reset,
    .form-all .form-submit-print {
      font-family: Roboto, sans-serif;
    }
    .form-all .form-pagebreak-back-container,
    .form-all .form-pagebreak-next-container {
      font-family: Roboto, sans-serif;
    }
    .form-header-group {
      font-family: Roboto, sans-serif;
    }
    .form-label {
      font-family: Roboto, sans-serif;
    }
  
    .form-label.form-label-auto {
      
    display: block;
    float: none;
    text-align: left;
    width: 100%;
  
    }
  
    .form-line {
      margin-top: 5px;
      margin-bottom: 5px;
    }
  
    .form-all {
      max-width: 480px;
      width: 100%;
    }
  
    .form-label.form-label-left,
    .form-label.form-label-right,
    .form-label.form-label-left.form-label-auto,
    .form-label.form-label-right.form-label-auto {
      width: 150px;
    }
  
    .form-all {
      font-size: 14px
    }
    .form-all .qq-upload-button,
    .form-all .qq-upload-button,
    .form-all .form-submit-button,
    .form-all .form-submit-reset,
    .form-all .form-submit-print {
      font-size: 14px
    }
    .form-all .form-pagebreak-back-container,
    .form-all .form-pagebreak-next-container {
      font-size: 14px
    }
  
    .supernova .form-all, .form-all {
      background-color: #fff;
    }
  
    .form-all {
      color: #555;
    }
    .form-header-group .form-header {
      color: #555;
    }
    .form-header-group .form-subHeader {
      color: #555;
    }
    .form-label-top,
    .form-label-left,
    .form-label-right,
    .form-html,
    .form-checkbox-item label,
    .form-radio-item label,
    span.FITB .qb-checkbox-label,
    span.FITB .qb-radiobox-label,
    span.FITB .form-radio label,
    span.FITB .form-checkbox label,
    [data-blotid][data-type=checkbox] [data-labelid],
    [data-blotid][data-type=radiobox] [data-labelid],
    span.FITB-inptCont[data-type=checkbox] label,
    span.FITB-inptCont[data-type=radiobox] label {
      color: #555;
    }
    .form-sub-label {
      color: #6f6f6f;
    }
  
    .supernova {
      background-color: rgb(255, 255, 255);
    }
    .supernova body {
      background: transparent;
    }
  
    .form-textbox,
    .form-textarea,
    .form-dropdown,
    .form-radio-other-input,
    .form-checkbox-other-input,
    .form-captcha input,
    .form-spinner input {
      background-color: #fff;
    }
  
    .supernova {
      background-image: none;
    }
    #stage {
      background-image: none;
    }
  
    .form-all {
      background-image: none;
    }
  
    .form-all {
      position: relative;
    }
    .form-all:before {
      content: "";
      background-image: url("https://www.jotform.com/uploads/WEBSITEFLIX/form_files/mainpage3-1024x437.63eaa847ec0858.24639219.jpg");
      display: inline-block;
      height: 204.8780487804878px;
      position: absolute;
      background-size: 480px 204px;
      background-repeat: no-repeat;
      width: 100%;
    }
    .form-all {
      margin-top: 214px !important;
    }
    .form-all:before {
      top: -214px;
      background-position: top center;
      left: 0;
    }
           
  .ie-8 .form-all:before { display: none; }
  .ie-8 {
    margin-top: auto;
    margin-top: initial;
  }
  
  /*PREFERENCES STYLE*//*__INSPECT_SEPERATOR__*/
/*---------------------
Theme: Generic Theme
Author: Elton Cris - idarktech@jotform.com
www.jotform.com
----------------------*/
.form-all {
    -moz-box-sizing : border-box;
    -webkit-box-sizing : border-box;
    box-sizing : border-box;
    -moz-box-shadow : 0 1px 4px rgba(0, 0, 0, .25);
    -webkit-box-shadow : 0 1px 4px rgba(0, 0, 0, .25);
    box-shadow : 0 1px 4px rgba(0, 0, 0, .25) !important;
    width: 100% !important;
}

[data-type="control_head"] {
    padding-bottom : 20px;
}

/*responsive fields*/
[data-type="control_textbox"] .form-textbox, 
[data-type="control_fullname"] .form-textbox,
[data-type="control_email"] .form-textbox,
[data-type="control_textarea"] .form-textarea, 
[data-type="control_dropdown"] .form-dropdown {
    width : 100% !important;
    max-width : none !important;
}

.form-textbox, .form-textarea, .form-dropdown {
    max-width : none !important;
    box-shadow : none;
    outline : none;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
    -moz-box-sizing : border-box;
    font-family : inherit;
    padding : 8px;
    transition : .3s ease-in-out;
    box-shadow : 0 1px 2px rgba(0, 0, 0, .15) inset;
}

.form-textarea-limit>span {
    display : block;
}

[data-type="control_dropdown"] .form-input, 
[data-type="control_dropdown"] .form-input-wide {
    width : 100%;
}

/*input focus*/
.form-line-active input:focus, .form-line-active textarea:focus, .form-line-active select:focus {
    outline : 0;
    border-color : 1px solid rgba(82, 168, 236, 0.8) !important;
    box-shadow : inset 0 1px 3px rgba(0, 0, 0, 0.1),0 0 8px rgba(82, 168, 236, 0.6);
}

/*reset error*/
.form-line-error {
    box-shadow : none;
}

/*input error*/
.form-line-error input:not(#coupon-input), .form-line-error textarea, .form-line-error select, .form-line-error .form-validation-error {
    border : 1px solid #e15353 !important;
    box-shadow : none !important;
}

.form-line-active {
    color : inherit !important;
}

/*responsive content -wide or shrink*/
.form-label {
    width : 35% !important;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
    -moz-box-sizing : border-box;
}

.form-label-top {
    width : 100% !important;
}

.form-line {
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
    -moz-box-sizing : border-box;
    width : 100%;
}

.form-checkbox-other-input {
    width : 80% !important;
}

.form-input {
    width : 65% !important;
    max-width : none !important;
}

.form-input-wide {
    max-width : none !important;
    display : inline-block;
    width : 100%;
}

/*single fields with sublabels*/
[data-type="control_textbox"] .form-input-wide .form-sub-label-container, 
[data-type="control_fullname"] .form-input-wide .form-sub-label-container,
[data-type="control_email"] .form-input-wide .form-sub-label-container,
[data-type="control_textarea"] .form-input-wide .form-sub-label-container, 
[data-type="control_dropdown"] .form-input-wide .form-sub-label-container,
[data-type="control_textbox"] .form-input .form-sub-label-container, 
[data-type="control_fullname"] .form-input .form-sub-label-container,
[data-type="control_email"] .form-input .form-sub-label-container,
[data-type="control_textarea"] .form-input .form-sub-label-container, 
[data-type="control_dropdown"] .form-input .form-sub-label-container {
    width : 100%;
    max-width : none !important;
}

[data-type="control_dropdown"] .form-input-wide {
    width : 100%;
}

/*responsive full name*/
[data-type="control_fullname"] .form-sub-label-container {
    width : 50% !important;
    margin : 0 !important;
    float : left;
    box-sizing : border-box;
}

[data-type="control_fullname"] .form-label + div .form-sub-label-container {
    display : inline-block;
    padding-right : 5px;
}

[data-type="control_fullname"] .form-label + div .form-sub-label-container + .form-sub-label-container {
    margin-right : 0;
    padding-right : 0;
    padding-left : 5px;
}

[data-type="control_fullname"] .form-label + div .form-sub-label-container + .form-sub-label-container {
    margin-right : 0;
    padding-right : 0;
    padding-left : 5px;
}

[data-type="control_fullname"] .form-label + div .form-sub-label-container + .form-sub-label-container + .form-sub-label-container {
    padding-left : 0;
    padding-right : 5px;
}

[data-type="control_fullname"] .form-label + div .form-sub-label-container + .form-sub-label-container + .form-sub-label-container + .form-sub-label-container {
    padding-left : 5px;
    padding-right : 0;
}

[data-type="control_fullname"] .form-label + div .form-sub-label-container + .form-sub-label-container  + .form-sub-label-container + .form-sub-label-container + .form-sub-label-container {
    padding-right : 5px;
    padding-left : 0;
}

#sublabel_prefix, #sublabel_first, #sublabel_middle {
    /*margin-bottom : 10px;
    */;
}

/*remove sepatators on date and phone*/
.phone-separate, .date-separate {
    display : none;
}

/*responsive phone fields*/
[data-type="control_phone"] input[name$="[area]"] {
    width : 100%;
}

[data-type="control_phone"] input[name$="[phone]"] {
    width : 100%;
}

[data-type="control_phone"] input[name$="[full]"] {
    width : 100%;
}

[data-type="control_phone"] .form-sub-label-container {
    width : 40%;
    float : left;
    box-sizing : border-box;
    margin-right : 0;
    padding-right : 12px;
}

/* responsive date time field */
[data-type="control_datetime"] .form-textbox,
[data-type="control_datetime"] .form-dropdown {
    width : 100%;
}

[data-type="control_datetime"] .form-sub-label-container {
    width : 28%;
    padding-left : 4px;
    box-sizing : border-box;
    margin-right : 0;
}

[data-type="control_datetime"] .form-sub-label-container:first-child {
    padding-left : 0;
}

[data-type="control_datetime"] .form-sub-label-container:first-child + .form-sub-label-container + .form-sub-label-container {
    padding-right : 0;
}

[data-type="control_datetime"] .form-sub-label-container:last-child {
    width : auto !important;
}

.allowTime-container .form-sub-label-container:last-child {
    width : 20% !important;
}

span.allowTime-container {
    width : 80%;
    padding-top : 14px;
}

.allowTime-container span.form-sub-label-container {
    width : 35%;
}

span.allowTime-container .form-dropdown {
    width : 100%;
}

span.allowTime-container > span:first-child {
    display : none;
}

span.allowTime-container > span:first-child + span {
    padding-left : 0;
}

.showAutoCalendar + label {
    display : none;
}

span.allowTime-container + span {
    padding-top : 14px;
}

/*calendar lite mode*/
[data-type="control_datetime"] div[style*="none"] + .form-sub-label-container {
    width : 84%;
    padding-left : 0;
}

/*responsive phone field*/
[data-type="control_phone"] .form-sub-label-container + .form-sub-label-container {
    width : 60%;
    margin-right : 0;
    padding-right : 0;
    padding-left : 12px;
}

/*responsive full address fields*/
.form-address-city, .form-address-line, .form-address-postal, 
.form-address-state, .form-address-table, 
.form-address-table .form-sub-label-container, .form-address-table select {
    width : 100%;
    max-width : 100%;
}

[data-type="control_address"] input[name$="[city]"],
[data-type="control_address"] input[name$="[postal]"] {
    width : 90% !important;
}

[data-type="control_address"] input[name$="[area]"] {
    width : 60%;
}

/*reset submit button*/
[data-type="control_button"] {
    background : transparent !important;
}

.form-submit-button,
.form-submit-reset,
.form-submit-print {
    outline : none;
}

/*remove other checkbox*/
.form-checkbox-other, 
.form-radio-other {
    visibility : hidden !important;
}

/*shruken fields*/
.form-line-column {
    width : 50%;
}

.form-line-column .form-label-top {
    width : 100% !important;
}

/*fix form builder display*/
div#stage.form-all {
    max-width : none !important;
    margin-right : 0;
}

div#stage .form-input {
    width : 64% !important;
}

/*remove first pagebreak back button*/
.form-all .page-section:first-child .form-pagebreak .form-pagebreak-back-container {
    display : none !important;
}

/* responsive pagebreak */
.form-pagebreak-back-container {
    width : 50% !important;
    text-align : left;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
    float : left;
}

.form-pagebreak-next-container {
    width : 50% !important;
    text-align : right;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
    float : left;
}

/* radio-checkbox button make border 1px */
.form-radio-item:not(#foo) label:after,
.form-radio-item:not(#foo) label:before {
    border-radius : 50%;
}

.form-checkbox-item:not(#foo) label:after,
.form-checkbox-item:not(#foo) label:before {
    border-radius : 0;
}

.form-radio-item:not(#foo) label:before,
.form-checkbox-item:not(#foo) label:before {
    border-width : 1px;
}

/*responsive credit card on payment fields*/
table td + td {
    padding-left : 0;
}

.form-address-table {
    width : 100%;
}

[data-type="control_stripe"] .form-address-table,
[data-type="control_stripe"] .form-address-table .form-textbox,
[data-type="control_authnet"] .form-address-table,
[data-type="control_authnet"] .form-address-table .form-textbox,
#creditCardTable.form-address-table,
#creditCardTable.form-address-table .form-textbox {
    max-width : none;
}

[data-type="control_stripe"] .form-address-table td:last-child .form-sub-label-container,
[data-type="control_authnet"] .form-address-table td:last-child .form-sub-label-container,
#creditCardTable.form-address-table td:last-child .form-sub-label-container {
    margin-left : 0;
    white-space : normal;
}

[data-type="control_stripe"] .form-address-table td .form-sub-label-container,
[data-type="control_authnet"] .form-address-table td .form-sub-label-container,
#creditCardTable.form-address-table td .form-sub-label-container {
    width : 100%;
}

[data-type="control_stripe"] .form-address-table .form-textbox,
[data-type="control_stripe"] .form-address-table .form-dropdown,
[data-type="control_authnet"] .form-address-table .form-textbox,
[data-type="control_authnet"] .form-address-table .form-dropdown,
#creditCardTable.form-address-table .form-textbox,
#creditCardTable.form-address-table .form-dropdown {
    width : 100%;
    visibility : visible;
}

[data-type="control_stripe"] .form-address-table tbody > tr:first-child + tr td:first-child span,
[data-type="control_authnet"] .form-address-table tbody > tr:first-child + tr td:first-child span,
#creditCardTable.form-address-table tbody > tr:first-child + tr td:first-child span {
    margin : 0;
    padding-right : 6px;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
}

[data-type="control_stripe"] .form-address-table tbody > tr:first-child + tr td:first-child + td span,
[data-type="control_authnet"] .form-address-table tbody > tr:first-child + tr td:first-child + td span,
#creditCardTable.form-address-table tbody > tr:first-child + tr td:first-child + td span {
    margin : 0;
    padding-left : 6px;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
}

[data-type="control_stripe"] .form-address-table tbody > tr:first-child + tr +tr td:first-child span,
[data-type="control_stripe"] .form-address-table tbody > tr:first-child + tr +tr+tr td:first-child span,
[data-type="control_authnet"] .form-address-table tbody > tr:first-child + tr +tr td:first-child span,
[data-type="control_authnet"] .form-address-table tbody > tr:first-child + tr +tr+tr td:first-child span,
#creditCardTable.form-address-table tbody > tr:first-child + tr +tr td:first-child span,
#creditCardTable.form-address-table tbody > tr:first-child + tr +tr+tr td:first-child span {
    margin : 0;
    padding-right : 6px;
    width : 50% !important;
    visibility : hidden;
    float : left;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
}

[data-type="control_stripe"] .form-address-table tbody > tr:first-child + tr +tr td:first-child span + span,
[data-type="control_stripe"] .form-address-table tbody > tr:first-child + tr +tr+tr td:first-child span + span,
[data-type="control_authnet"] .form-address-table tbody > tr:first-child + tr +tr td:first-child span + span,
[data-type="control_authnet"] .form-address-table tbody > tr:first-child + tr +tr+tr td:first-child span + span,
#creditCardTable.form-address-table tbody > tr:first-child + tr +tr td:first-child span + span,
#creditCardTable.form-address-table tbody > tr:first-child + tr +tr+tr td:first-child span + span {
    margin : 0;
    padding-top : 0 !important;
    padding-right : 0;
    padding-left : 6px;
    width : 50% !important;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
}

.cc_ccv {
    width : 100% !important;
}

[data-type="control_stripe"] .form-address-table .form-sub-label,
[data-type="control_authnet"] .form-address-table .form-sub-label,
#creditCardTable.form-address-table .form-sub-label {
    visibility : visible;
}

/*cc fix city state, country */
[data-type="control_stripe"] .form-address-table td[width="50%"]>span:first-child,
[data-type="control_authnet"] .form-address-table td[width="50%"]>span:first-child,
#creditCardTable.form-address-table td[width="50%"]>span:first-child {
    box-sizing : border-box;
    padding-right : 7px;
}

[data-type="control_stripe"] .form-address-table td[width="50%"] + td >span:first-child,
[data-type="control_authnet"] .form-address-table td[width="50%"] + td >span:first-child,
#creditCardTable.form-address-table td[width="50%"] + td >span:first-child {
    box-sizing : border-box;
    padding-left : 7px;
}

[data-type="control_stripe"] .form-address-table td[width="50%"] + td[width="50%"] >span:first-child,
[data-type="control_authnet"] .form-address-table td[width="50%"] + td[width="50%"] >span:first-child,
#creditCardTable.form-address-table td[width="50%"] + td[width="50%"] >span:first-child {
    box-sizing : border-box;
    padding-right : 0;
}

.hover-product-item:hover {
    color : inherit;
}

/*fix for braintree cc styling*/
[data-type="control_braintree"] .form-sub-label-container {
    width : 100% !important;
    padding : 4px;
    box-sizing : border-box;
}

[data-type="control_braintree"] .form-textbox {
    width : 100%;
}

.braintree-hosted-fields {
    width : 100% !important;
    box-sizing : border-box;
    min-height : 28px;
}

/*remove bottom spacing on CC section*/
#creditCardTable.form-address-table tbody tr + tr + tr td,
[data-type="control_stripe"] .form-address-table tbody tr + tr + tr td,
[data-type="control_authnet"] .form-address-table tbody tr + tr + tr td {
    padding-bottom : 0;
}

@media screen and (max-device-width:768px){
    .form-all {
        margin : 0 auto !important;
        width : 100% !important;
    }

    [data-type=control_fullname] .form-sub-label-container:first-child {
        margin-right : 0;
    }

}

@media screen and (max-width:480px){
    .jotform-form {
        padding : 0;
    }

    .form-input {
        width : 100% !important;
    }

    .form-label {
        width : 100% !important;
        float : none !important;
    }

    .form-line-column {
        width : 100% !important;
    }

    div.form-header-group {
        margin : 0 !important;
        padding : 24px 20px !important;
    }

    [data-type="control_datetime"] .form-sub-label-container {
        float : left;
    }

    [data-type=control_fullname] .form-sub-label-container:first-child {
        margin-right : 0;
    }

}

/*----fix the new awful error message----*/
li.form-line-error .form-error-message img {
    position: static !important;
    margin-top: 0;
    left: 0;
    top: 0;
    vertical-align: middle;
    padding: 2px 0;
}
li.form-line-error .form-error-message {
    padding: 2px 6px;
}
    /* Injected CSS Code */
</style>

<link type="text/css" rel="stylesheet" href="https://cdn02.jotfor.ms/css/styles/buttons/form-submit-button-black_blue.css?3.3.39251"/>
<form class="jotform-form" action="https://submit.jotform.com/submit/222014867361150/" method="post" name="form_222014867361150" id="222014867361150" accept-charset="utf-8" autocomplete="off"><input type="hidden" name="formID" value="222014867361150" /><input type="hidden" id="JWTContainer" value="" /><input type="hidden" id="cardinalOrderNumber" value="" />
  <div role="main" class="form-all">
    <link type="text/css" rel="stylesheet" media="all" href="https://cdn.jotfor.ms/wizards/languageWizard/custom-dropdown/css/lang-dd.css?3.3.39251" />
    <div class="cont"><input type="text" id="input_language" name="input_language" style="display:none" />
      <div class="language-dd" id="langDd" style="display:none">
        <div class="dd-placeholder lang-emp">Language</div>
        <ul class="lang-list dn" id="langList">
          <li data-lang="en" class="en">English (US)</li>
        </ul>
      </div>
    </div>
    <script type="text/javascript" src="https://cdn.jotfor.ms/js/formTranslation.v2.js?3.3.39251"></script>
    <ul class="form-section page-section">
      <li class="form-line" data-type="control_text" id="id_23">
        <div id="cid_23" class="form-input-wide">
          <div id="text_23" class="form-html" data-component="text" tabindex="0">
            <p>Bring <strong>Keynote Safety Speaker Charlie Morecraft</strong> to your facility to deliver a very powerful, profound and impactful safety message that will alter people’s attitude towards safety forever! GUARANTEED!</p>
            <p>For pricing and availability please send us an email at <a href="mailto:info@charliemorecraft.com" target="_blank" rel="nofollow">info@charliemorecraft.com</a> or fill out the form below.</p>
            <p>Contact Details: +1 (561) 997-1120 <br />Toll Free: (800) 783-0796<br />Email: <a href="mailto:info@charliemorecraft.com" target="_blank" rel="nofollow">info@charliemorecraft.com</a> <br />Website: <a href="https://charliemorecraft.com/motivational-safety-presentations/" target="_blank" rel="nofollow">https://charliemorecraft.com/motivational-safety-presentations/</a></p>
          </div>
        </div>
      </li>
      <li class="form-line jf-required" data-type="control_textbox" id="id_20"><label class="form-label form-label-top form-label-auto" id="label_20" for="input_20"> Company<span class="form-required">*</span> </label>
        <div id="cid_20" class="form-input-wide jf-required"> <input type="text" id="input_20" name="q20_company" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="20" value="" data-component="textbox" aria-labelledby="label_20" required="" /> </div>
      </li>
      <li class="form-line form-line-column form-col-1 jf-required" data-type="control_textbox" id="id_3"><label class="form-label form-label-top" id="label_3" for="input_3"> First Name<span class="form-required">*</span> </label>
        <div id="cid_3" class="form-input-wide jf-required"> <input type="text" id="input_3" name="q3_firstName" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="23" value="" placeholder=" " data-component="textbox" aria-labelledby="label_3" required="" /> </div>
      </li>
      <li class="form-line form-line-column form-col-2 jf-required" data-type="control_textbox" id="id_9"><label class="form-label form-label-top" id="label_9" for="input_9"> Last Name<span class="form-required">*</span> </label>
        <div id="cid_9" class="form-input-wide jf-required"> <input type="text" id="input_9" name="q9_lastName" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="25" value="" placeholder=" " data-component="textbox" aria-labelledby="label_9" required="" /> </div>
      </li>
      <li class="form-line form-line-column form-col-1 form-line-column-clear jf-required" data-type="control_textbox" id="id_10"><label class="form-label form-label-top" id="label_10" for="input_10"> E-mail<span class="form-required">*</span> </label>
        <div id="cid_10" class="form-input-wide jf-required"> <input type="text" id="input_10" name="q10_email10" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="23" value="" placeholder=" " data-component="textbox" aria-labelledby="label_10" required="" /> </div>
      </li>
      <li class="form-line form-line-column form-col-2 jf-required" data-type="control_textbox" id="id_11"><label class="form-label form-label-top" id="label_11" for="input_11"> Phone<span class="form-required">*</span> </label>
        <div id="cid_11" class="form-input-wide jf-required"> <input type="text" id="input_11" name="q11_phone" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="25" value="" placeholder=" " data-component="textbox" aria-labelledby="label_11" required="" /> </div>
      </li>
      <li class="form-line" data-type="control_textarea" id="id_25"><label class="form-label form-label-top form-label-auto" id="label_25" for="input_25"> Event Date(s) and/or Location(s) </label>
        <div id="cid_25" class="form-input-wide"> <textarea id="input_25" class="form-textarea" name="q25_eventDates" cols="40" rows="6" data-component="textarea" aria-labelledby="label_25"></textarea> </div>
      </li>
      <li class="form-line jf-required" data-type="control_textarea" id="id_19"><label class="form-label form-label-top form-label-auto" id="label_19" for="input_19"> Message<span class="form-required">*</span> </label>
        <div id="cid_19" class="form-input-wide jf-required"> <textarea id="input_19" class="form-textarea validate[required]" name="q19_message" cols="70" rows="6" data-component="textarea" required="" aria-labelledby="label_19"></textarea> </div>
      </li>
      <li class="form-line jf-required" data-type="control_captcha" id="id_21"><label class="form-label form-label-top form-label-auto" id="label_21" for="input_21"> Please verify that you are human<span class="form-required">*</span> </label>
        <div id="cid_21" class="form-input-wide jf-required">
          <section data-wrapper-react="true">
            <div id="recaptcha_input_21" data-component="recaptcha" data-callback="recaptchaCallbackinput_21" data-expired-callback="recaptchaExpiredCallbackinput_21"></div><input type="hidden" id="input_21" class="hidden validate[required]" name="recaptcha_visible" required="" />
            <script type="text/javascript" src="https://www.google.com/recaptcha/api.js?render=explicit&amp;onload=recaptchaLoadedinput_21"></script>
            <script type="text/javascript">
              var recaptchaLoadedinput_21 = function()
              {
                window.grecaptcha.render($("recaptcha_input_21"),
                {
                  sitekey: '6LdU3CgUAAAAAB0nnFM3M3T0sy707slYYU51RroJ',
                });
                var grecaptchaBadge = document.querySelector('.grecaptcha-badge');
                if (grecaptchaBadge)
                {
                  grecaptchaBadge.style.boxShadow = 'gray 0px 0px 2px';
                }
              };

              /**
               * Called when the reCaptcha verifies the user is human
               * For invisible reCaptcha;
               *   Submit event is stopped after validations and recaptcha is executed.
               *   If a challenge is not displayed, this will be called right after grecaptcha.execute()
               *   If a challenge is displayed, this will be called when the challenge is solved successfully
               *   Submit is triggered to actually submit the form since it is stopped before.
               */
              var recaptchaCallbackinput_21 = function()
              {
                var isInvisibleReCaptcha = false;
                var hiddenInput = $("input_21");
                hiddenInput.setValue(1);
                if (!isInvisibleReCaptcha)
                {
                  if (hiddenInput.validateInput)
                  {
                    hiddenInput.validateInput();
                  }
                }
                else
                {
                  triggerSubmit(hiddenInput.form)
                }

                function triggerSubmit(formElement)
                {
                  var button = formElement.ownerDocument.createElement('input');
                  button.style.display = 'none';
                  button.type = 'submit';
                  formElement.appendChild(button).click();
                  formElement.removeChild(button);
                }
              }

              // not really required for invisible recaptcha
              var recaptchaExpiredCallbackinput_21 = function()
              {
                var hiddenInput = $("input_21");
                hiddenInput.writeAttribute("value", false);
                if (hiddenInput.validateInput)
                {
                  hiddenInput.validateInput();
                }
              }
            </script>
          </section>
        </div>
      </li>
      <li class="form-line" data-type="control_button" id="id_8">
        <div id="cid_8" class="form-input-wide">
          <div data-align="center" class="form-buttons-wrapper form-buttons-center   jsTest-button-wrapperField"><button id="input_8" type="submit" class="form-submit-button form-submit-button-black_blue submit-button jf-form-buttons jsTest-submitField" data-component="button" data-content="">Submit</button></div>
        </div>
      </li>
      <li style="display:none">Should be Empty: <input type="text" name="website" value="" /></li>
    </ul>
  </div>
  <script>
    JotForm.showJotFormPowered = "0";
  </script>
  <script>
    JotForm.poweredByText = "Powered by Jotform";
  </script><input type="hidden" class="simple_spc" id="simple_spc" name="simple_spc" value="222014867361150" />
  <script type="text/javascript">
    var all_spc = document.querySelectorAll("form[id='222014867361150'] .si" + "mple" + "_spc");
    for (var i = 0; i < all_spc.length; i++)
    {
      all_spc[i].value = "222014867361150-222014867361150";
    }
  </script>
</form><script type="text/javascript">JotForm.ownerView=true;</script></p>
<p>The post <a href="https://www.charlieonsafety.com/charlie-morecraft-motivational-safety-speaker-and-safety-coach/">Charlie Morecraft – Motivational Safety Speaker and Safety Coach</a> appeared first on <a href="https://www.charlieonsafety.com">Charlie Morecraft</a>.</p>
]]></content:encoded>
					
		
		
			</item>
		<item>
		<title>Charlie&#8217;s Speakers Team &#8211; Michael Melnik M.S., O.T.R</title>
		<link>https://www.charlieonsafety.com/charlies-speakers-team-michael-melnik-m-s-o-t-r/</link>
		
		<dc:creator><![CDATA[Charlie Morecraft]]></dc:creator>
		<pubDate>Mon, 21 Jun 2021 18:15:33 +0000</pubDate>
				<category><![CDATA[Speaker's Team]]></category>
		<category><![CDATA[Speaker's team]]></category>
		<guid isPermaLink="false">https://www.charlieonsafety.com/?p=2258</guid>

					<description><![CDATA[<p>We are proud to have Michael S. Melnik M.S., O.T.R. as part of our speaker’s team! Michael S. Melnik Biography Michael Melnik is an occupational therapist with a master’s degree in exercise physiology, focused on helping organizations “Energize” their programs and their people. For more than 30 years he has presented his practical, high energy &#8230; </p>
<p>The post <a href="https://www.charlieonsafety.com/charlies-speakers-team-michael-melnik-m-s-o-t-r/">Charlie&#8217;s Speakers Team &#8211; Michael Melnik M.S., O.T.R</a> appeared first on <a href="https://www.charlieonsafety.com">Charlie Morecraft</a>.</p>
]]></description>
										<content:encoded><![CDATA[<h4>We are proud to have Michael S. Melnik M.S., O.T.R. as part of our speaker’s team!</h4>
<h3>Michael S. Melnik Biography</h3>
<p>Michael Melnik is an occupational therapist with a master’s degree in exercise physiology, focused on helping organizations “Energize” their programs and their people. For more than 30 years he has presented his practical, high energy and humorous approach to over 750,000 participants around the world.  He is the author and talent in several award-winning injury prevention videos in use by thousands of companies. Some of his clients include Coca Cola, Best Buy, Wells Fargo, Exxon-Mobil, PetSmart, The Home Depot, General Mills, Wal-Mart and many others.</p>
<h3>On-Site Presentations</h3>
<h5><strong>1. The Energized Approach for Creating a Safe, Healthy and Productive Workplace</strong></h5>
<p><strong>Target Audience:</strong> Managers, Supervisors, leads and anyone with a responsibility for the safety of employees.</p>
<p>Those in a position of responsibility are often faced with the monumental task of “introducing change” and “getting everyone on board”. Keeping employees actively engaged in the safety process can be a daunting, time-consuming and often thankless task. The <strong>Energized Approach </strong>provides the leadership team with effective strategies to “generate and capture” the energy needed to drive safe behaviors and insure that the company’s safety efforts generate the maximum return on investment. In this fun, high energy and information packed session Michael introduces the 10 essential energy sources and demonstrates how this time-tested approach reduces resistance and maximizes participation. The Energized Approach energizes participants and offers them a strategy that helps them create a work environment that is primed for action.</p>
<h5><strong>2. From Knowing to Doing: Effective Safety Training</strong></h5>
<p><strong>Target Audience:</strong> Managers, Supervisors, leads and anyone with responsibility for the safety of employees.</p>
<p>For years, the delivery of information has been the method of choice for inviting safe employee behaviors. Unfortunately it has become clear that there is a huge difference between what employees know and what they do with what they know. While information certainly has value, its impact is influenced not only by the quantity of content delivered, but also by HOW the content is developed, delivered, supported and received! In this session Michael introduces REP; The Rational, Emotional and Physical approach to effective training. This fun, high energy session takes a humorous look at training and offers insights and strategies for training that not only influence what participants know, but also what they do with what they know.</p>
<h5><strong>3. The Lighter Side of Sitting, Standing, Lifting and Stretching</strong></h5>
<p><strong>Target Audience:</strong> Everyone</p>
<p>This high energy, fun and interactive session examines the myths and misconceptions surrounding “proper” body mechanics and offers practical and effective strategies to reduce claims and increase productivity. This fun, high energy and interactive presentation has been shared with hundreds of thousands of employees over the years to rave reviews and has been an integral part of the injury prevention programs of numerous Fortune 500 companies.</p>
<h4>To inquire about Melnik&#8217;s presentations please call our office at (800) 783-0796, contact us by email at <a href="mailto:info@charliemorecraft.com">info@charliemorecraft.com</a> or fill out the form below.</h4>
<h3 style="margin-top: 40px;">Melnik – Presentation Inquiry</h3>
<script src="https://cdn03.jotfor.ms/static/prototype.forms.js?3.3.39252" type="text/javascript"></script>
<script src="https://cdn01.jotfor.ms/static/jotform.forms.js?3.3.39252" type="text/javascript"></script>
<script type="text/javascript">	JotForm.newDefaultTheme = false;
	JotForm.extendsNewTheme = false;
	JotForm.singleProduct = false;
	JotForm.newPaymentUIForNewCreatedForms = false;
	JotForm.highlightInputs = false;

	JotForm.init(function(){
	/*INIT-START*/
if (window.JotForm && JotForm.accessible) $('input_20').setAttribute('tabindex',0);
if (window.JotForm && JotForm.accessible) $('input_3').setAttribute('tabindex',0);
if (window.JotForm && JotForm.accessible) $('input_9').setAttribute('tabindex',0);
if (window.JotForm && JotForm.accessible) $('input_10').setAttribute('tabindex',0);
if (window.JotForm && JotForm.accessible) $('input_11').setAttribute('tabindex',0);
if (window.JotForm && JotForm.accessible) $('input_25').setAttribute('tabindex',0);
if (window.JotForm && JotForm.accessible) $('input_19').setAttribute('tabindex',0);
      JotForm.alterTexts({"ageVerificationError":"You must be older than {minAge} years old to submit this form.","alphabetic":"This field can only contain letters","alphanumeric":"This field can only contain letters and numbers.","appointmentSelected":"You’ve selected {time} on {date}","ccDonationMinLimitError":"Minimum amount is {minAmount} {currency}","ccInvalidCVC":"CVC number is invalid.","ccInvalidExpireDate":"Expire date is invalid.","ccInvalidExpireMonth":"Expiration month is invalid.","ccInvalidExpireYear":"Expiration year is invalid.","ccInvalidNumber":"Credit Card Number is invalid.","ccMissingDetails":"Please fill up the credit card details.","ccMissingDonation":"Please enter numeric values for donation amount.","ccMissingProduct":"Please select at least one product.","characterLimitError":"Too many Characters.  The limit is","characterMinLimitError":"Too few characters. The minimum is","confirmClearForm":"Are you sure you want to clear the form","confirmEmail":"E-mail does not match","currency":"This field can only contain currency values.","cyrillic":"This field can only contain cyrillic characters","dateInvalid":"This date is not valid. The date format is {format}","dateInvalidSeparate":"This date is not valid. Enter a valid {element}.","dateLimited":"This date is unavailable.","disallowDecimals":"Please enter a whole number.","doneButton":"Done","doneMessage":"Well done! All errors are fixed.","dragAndDropFilesHere_infoMessage":"Drag and drop files here","email":"Enter a valid e-mail address","fillMask":"Field value must fill mask.","freeEmailError":"Free email accounts are not allowed","generalError":"There are errors on the form. Please fix them before continuing.","generalPageError":"There are errors on this page. Please fix them before continuing.","geoNotAvailableDesc":"Location provider not available. Please enter the address manually.","geoNotAvailableTitle":"Position Unavailable","geoPermissionDesc":"Check your browser's privacy settings.","geoPermissionTitle":"Permission Denied","geoTimeoutDesc":"Please check your internet connection and try again.","geoTimeoutTitle":"Timeout","gradingScoreError":"Score total should only be less than or equal to","incompleteFields":"There are incomplete required fields. Please complete them.","inputCarretErrorA":"Input should not be less than the minimum value:","inputCarretErrorB":"Input should not be greater than the maximum value:","justSoldOut":"Just Sold Out","lessThan":"Your score should be less than or equal to","maxDigitsError":"The maximum digits allowed is","maxFileSize_infoMessage":"Max. file size","maxSelectionsError":"The maximum number of selections allowed is ","minCharactersError":"The number of characters should not be less than the minimum value:","minSelectionsError":"The minimum required number of selections is ","multipleError":"There are {count} errors in this page. Please correct them before moving on.","multipleFileUploads_emptyError":"{file} is empty, please select files again without it.","multipleFileUploads_fileLimitError":"Only {fileLimit} file uploads allowed.","multipleFileUploads_minSizeError":"{file} is too small, minimum file size is {minSizeLimit}.","multipleFileUploads_onLeave":"The files are being uploaded, if you leave now the upload will be cancelled.","multipleFileUploads_sizeError":"{file} is too large, maximum file size is {sizeLimit}.","multipleFileUploads_typeError":"{file} has invalid extension. Only {extensions} are allowed.","multipleFileUploads_uploadFailed":"File upload failed, please remove it and upload the file again.","noSlotsAvailable":"No slots available","notEnoughStock":"Not enough stock for the current selection","notEnoughStock_remainedItems":"Not enough stock for the current selection ({count} items left)","noUploadExtensions":"File has no extension file type (e.g. .txt, .png, .jpeg)","numeric":"This field can only contain numeric values","oneError":"There is {count} error in this page. Please correct it before moving on.","pastDatesDisallowed":"Date must not be in the past.","pleaseWait":"Please wait...","required":"This field is required.","requiredLegend":"All fields marked with * are required and must be filled.","requireEveryCell":"Every cell is required.","requireEveryRow":"Every row is required.","requireOne":"At least one field required.","restrictedDomain":"This domain is not allowed","seeErrorsButton":"See Errors","selectionSoldOut":"Selection Sold Out","slotUnavailable":"{time} on {date} has been selected is unavailable. Please select another slot.","soldOut":"Sold Out","subProductItemsLeft":"({count} items left)","uploadExtensions":"You can only upload following files:","uploadFilesize":"File size cannot be bigger than:","uploadFilesizemin":"File size cannot be smaller than:","url":"This field can only contain a valid URL","validateEmail":"You need to validate this e-mail","wordLimitError":"Too many words. The limit is","wordMinLimitError":"Too few words.  The minimum is"});
      FormTranslation.init({"detectUserLanguage":"1","firstPageOnly":"0","options":"English (US)","originalLanguage":"en","primaryLanguage":"en","saveUserLanguage":"1","showStatus":"flag-with-nation","theme":"light-theme","version":"2"});
	/*INIT-END*/
	});

   JotForm.prepareCalculationsOnTheFly([null,null,null,{"name":"firstName","qid":"3","text":"First Name","type":"control_textbox"},null,null,null,null,{"name":"submit","qid":"8","text":"Submit","type":"control_button"},{"name":"lastName","qid":"9","text":"Last Name","type":"control_textbox"},{"name":"email10","qid":"10","text":"E-mail","type":"control_textbox"},{"name":"phone","qid":"11","text":"Phone","type":"control_textbox"},null,null,null,null,null,null,null,{"name":"otherDetails","qid":"19","text":"Other Details","type":"control_textarea"},{"description":"","name":"company","qid":"20","subLabel":"","text":"Company","type":"control_textbox"},{"description":"","name":"pleaseVerify","qid":"21","text":"Please verify that you are human","type":"control_captcha"},null,{"name":"input23","qid":"23","text":"Bring Keynote Michael Melnik to your facility to deliver The Energized Approach for Creating a Safe, Healthy and Productive Workplace Target Audience: Managers, Supervisors, leads and anyone with a responsibility for the safety of employees.\nFor pricing and availability please send us an email at info@charliemorecraft.com or fill out the form below.\nContact Details: +1 (561) 997-1120Toll Free: (800) 783-0796Email: info@charliemorecraft.com Website: https:\u002F\u002Fwww.charliemorecraft.com\u002Fcharlies-speakers-team-michael-melnik-m-s-o-t-r\u002F\n ","type":"control_text"},null,{"description":"","name":"eventDates","qid":"25","subLabel":"","text":"Event Date(s) and\u002For Location(s)","type":"control_textarea"},{"description":"","name":"keynoteSafety","qid":"26","subLabel":"","text":"Keynote Safety Speaker","type":"control_dropdown"}]);
   setTimeout(function() {
JotForm.paymentExtrasOnTheFly([null,null,null,{"name":"firstName","qid":"3","text":"First Name","type":"control_textbox"},null,null,null,null,{"name":"submit","qid":"8","text":"Submit","type":"control_button"},{"name":"lastName","qid":"9","text":"Last Name","type":"control_textbox"},{"name":"email10","qid":"10","text":"E-mail","type":"control_textbox"},{"name":"phone","qid":"11","text":"Phone","type":"control_textbox"},null,null,null,null,null,null,null,{"name":"otherDetails","qid":"19","text":"Other Details","type":"control_textarea"},{"description":"","name":"company","qid":"20","subLabel":"","text":"Company","type":"control_textbox"},{"description":"","name":"pleaseVerify","qid":"21","text":"Please verify that you are human","type":"control_captcha"},null,{"name":"input23","qid":"23","text":"Bring Keynote Michael Melnik to your facility to deliver The Energized Approach for Creating a Safe, Healthy and Productive Workplace Target Audience: Managers, Supervisors, leads and anyone with a responsibility for the safety of employees.\nFor pricing and availability please send us an email at info@charliemorecraft.com or fill out the form below.\nContact Details: +1 (561) 997-1120Toll Free: (800) 783-0796Email: info@charliemorecraft.com Website: https:\u002F\u002Fwww.charliemorecraft.com\u002Fcharlies-speakers-team-michael-melnik-m-s-o-t-r\u002F\n ","type":"control_text"},null,{"description":"","name":"eventDates","qid":"25","subLabel":"","text":"Event Date(s) and\u002For Location(s)","type":"control_textarea"},{"description":"","name":"keynoteSafety","qid":"26","subLabel":"","text":"Keynote Safety Speaker","type":"control_dropdown"}]);}, 20); 
</script>
<link href="https://cdn01.jotfor.ms/static/formCss.css?3.3.39252" rel="stylesheet" type="text/css" />
<style type="text/css">@media print{.form-section{display:inline!important}.form-pagebreak{display:none!important}.form-section-closed{height:auto!important}.page-section{position:initial!important}}</style>
<link type="text/css" rel="stylesheet" href="https://cdn02.jotfor.ms/css/styles/nova.css?3.3.39252" />
<link type="text/css" rel="stylesheet" href="https://cdn03.jotfor.ms/themes/CSS/566a91c2977cdfcd478b4567.css?themeRevisionID=58c6459d9a11c7136a8b4567"/>
<link type="text/css" rel="stylesheet" href="https://cdn01.jotfor.ms/css/styles/payment/payment_feature.css?3.3.39252" />
<style type="text/css">


    .form-label-left{
        width:150px;
    }
    .form-line{
        padding-top:5px;
        padding-bottom:5px;
    }
    .form-label-right{
        width:150px;
    }
    .form-all{
        width:480px;
        color:#555 !important;
        font-family:'Roboto';
        font-size:14px;
    }
    .form-radio-item label, .form-checkbox-item label, .form-grading-label, .form-header{
        color: #0D0D0D;
    }

</style>

<style type="text/css" id="form-designer-style">
@import "https://fonts.googleapis.com/css?family=Roboto:light,lightitalic,normal,italic,bold,bolditalic";
@import (css) "@{buttonFontLink}";
    /* Injected CSS Code */

.form-all {
  font-family: "Roboto", sans-serif;
}
.form-all {
  width: 480px;
}
.form-label-left,
.form-label-right {
  width: 150px;
}
.form-label {
  white-space: normal;
}
.form-label.form-label-auto {
  display: block;
  float: none;
  text-align: left;
}
.form-label-left {
  display: inline-block;
  white-space: normal;
  float: left;
  text-align: left;
}
.form-label-right {
  display: inline-block;
  white-space: normal;
  float: left;
  text-align: right;
}
.form-label-top {
  white-space: normal;
  display: block;
  float: none;
  text-align: left;
}
.form-radio-item label:before {
  top: 0;
}
.form-all {
  font-size: 14px;
}
.form-label {
  font-weight: normal;
  font-size: 0.95em;
}
.supernova {
  background-color: #ffffff;
}
.supernova body {
  background-color: transparent;
}
/*
@width30: (unit(@formWidth, px) + 60px);
@width60: (unit(@formWidth, px)+ 120px);
@width90: (unit(@formWidth, px)+ 180px);
*/
/* | */
@media screen and (min-width: 480px) {
  .supernova .form-all {
    border: 1px solid #e6e6e6;
    -webkit-box-shadow: 0 3px 9px rgba(0, 0, 0, 0.1);
    -moz-box-shadow: 0 3px 9px rgba(0, 0, 0, 0.1);
    box-shadow: 0 3px 9px rgba(0, 0, 0, 0.1);
  }
}
/* | */
/* | */
@media screen and (max-width: 480px) {
  .jotform-form {
    padding: 10px 0;
  }
}
/* | */
/* | */
@media screen and (min-width: 480px) and (max-width: 768px) {
  .jotform-form {
    padding: 30px 0;
  }
}
/* | */
/* | */
@media screen and (min-width: 480px) and (max-width: 479px) {
  .jotform-form {
    padding: 30px 0;
  }
}
/* | */
/* | */
@media screen and (min-width: 768px) {
  .jotform-form {
    padding: 60px 0;
  }
}
/* | */
/* | */
@media screen and (max-width: 479px) {
  .jotform-form {
    padding: 12px;
  }
}
/* | */
.supernova .form-all,
.form-all {
  background-color: #ffffff;
  border: 1px solid transparent;
}
.form-header-group {
  border-color: #e6e6e6;
}
.form-matrix-table tr {
  border-color: #e6e6e6;
}
.form-matrix-table tr:nth-child(2n) {
  background-color: #f2f2f2;
}
.form-all {
  color: #555555;
}
.form-header-group .form-header {
  color: #555555;
}
.form-header-group .form-subHeader {
  color: #6f6f6f;
}
.form-sub-label {
  color: #6f6f6f;
}
.form-label-top,
.form-label-left,
.form-label-right,
.form-html {
  color: #6f6f6f;
}
.form-checkbox-item label,
.form-radio-item label {
  color: #555555;
}
.form-line.form-line-active {
  -webkit-transition-property: all;
  -moz-transition-property: all;
  -ms-transition-property: all;
  -o-transition-property: all;
  transition-property: all;
  -webkit-transition-duration: 0.3s;
  -moz-transition-duration: 0.3s;
  -ms-transition-duration: 0.3s;
  -o-transition-duration: 0.3s;
  transition-duration: 0.3s;
  -webkit-transition-timing-function: ease;
  -moz-transition-timing-function: ease;
  -ms-transition-timing-function: ease;
  -o-transition-timing-function: ease;
  transition-timing-function: ease;
  background-color: rgba(255, 255, 224, 0);
}
/* omer */
.form-radio-item,
.form-checkbox-item {
  padding-bottom: 0px !important;
}
.form-radio-item:last-child,
.form-checkbox-item:last-child {
  padding-bottom: 0;
}
/* omer */
.form-single-column .form-checkbox-item,
.form-single-column .form-radio-item {
  width: 100%;
}
.supernova {
  height: 100%;
  background-repeat: no-repeat;
  background-attachment: scroll;
  background-position: center top;
  background-repeat: repeat;
}
.supernova {
  background-image: none;
}
#stage {
  background-image: none;
}
/* | */
.form-all {
  background-repeat: no-repeat;
  background-attachment: scroll;
  background-position: center top;
  background-repeat: repeat;
}
.form-header-group {
  background-repeat: no-repeat;
  background-attachment: scroll;
  background-position: center top;
}
.form-line {
  margin-top: 0px;
  margin-bottom: 0px;
}
.form-line {
  padding: 8px 36px;
}
.form-all .form-textbox,
.form-all .form-radio-other-input,
.form-all .form-checkbox-other-input,
.form-all .form-captcha input,
.form-all .form-spinner input,
.form-all .form-pagebreak-back,
.form-all .form-pagebreak-next,
.form-all .qq-upload-button,
.form-all .form-error-message {
  -webkit-border-radius: 6px;
  -moz-border-radius: 6px;
  border-radius: 6px;
}
.form-all .form-sub-label {
  margin-left: 3px;
}
.form-all .form-textarea {
  -webkit-border-radius: 6px;
  -moz-border-radius: 6px;
  border-radius: 6px;
}
.form-all {
  -webkit-border-radius: 6px;
  -moz-border-radius: 6px;
  border-radius: 6px;
}
.form-section:first-child {
  -webkit-border-radius: 6px 6px 0 0;
  -moz-border-radius: 6px 6px 0 0;
  border-radius: 6px 6px 0 0;
}
.form-section:last-child {
  -webkit-border-radius: 0 0 6px 6px;
  -moz-border-radius: 0 0 6px 6px;
  border-radius: 0 0 6px 6px;
}
.form-all .qq-upload-button,
.form-all .form-submit-button,
.form-all .form-submit-reset,
.form-all .form-submit-print {
  font-size: 1em;
  padding: 9px 15px;
  font-family: "Roboto", sans-serif;
  font-size: 14px;
  font-weight: normal;
}
.form-all .form-pagebreak-back,
.form-all .form-pagebreak-next {
  font-size: 1em;
  padding: 9px 15px;
  font-family: "Roboto", sans-serif;
  font-size: 14px;
  font-weight: normal;
}
/*
& when ( @buttonFontType = google ) {
	
}
*/
h2.form-header {
  line-height: 1.618em;
  font-size: 1.714em;
}
h2 ~ .form-subHeader {
  line-height: 1.5em;
  font-size: 1.071em;
}
.form-header-group {
  text-align: left;
}
/*.form-dropdown,
.form-radio-item,
.form-checkbox-item,
.form-radio-other-input,
.form-checkbox-other-input,*/
.form-captcha input,
.form-spinner input,
.form-error-message {
  padding: 4px 3px 2px 3px;
}
.form-header-group {
  font-family: "Roboto", sans-serif;
}
.form-section {
  padding: 0px 0px 0px 0px;
}
.form-header-group {
  margin: 0px 0px 0px 0px;
}
.form-header-group {
  padding: 12px 36px 12px 36px;
}
.form-header-group {
  background-color: #f5f5f5;
}
.form-textbox,
.form-textarea {
  padding: 4px 3px 2px 3px;
}
.form-textbox,
.form-textarea,
.form-radio-other-input,
.form-checkbox-other-input,
.form-captcha input,
.form-spinner input {
  background-color: #ffffff;
}
[data-type="control_dropdown"] .form-input,
[data-type="control_dropdown"] .form-input-wide {
  width: 150px;
}
.form-label {
  font-family: "Roboto", sans-serif;
}
li[data-type="control_image"] div {
  text-align: left;
}
li[data-type="control_image"] img {
  border: none;
  border-width: 0px !important;
  border-style: solid !important;
  border-color: false !important;
}
.form-line-column {
  width: auto;
}
.form-line-error {
  background-color: #ffffff;
  -webkit-box-shadow: inset 0px 3px 11px -7px #ff3200;
  -moz-box-shadow: inset 0px 3px 11px -7px #ff3200;
  box-shadow: inset 0px 3px 11px -7px #ff3200;
}
.form-line-error input:not(#coupon-input),
.form-line-error textarea,
.form-line-error .form-validation-error {
  -webkit-transition-property: none;
  -moz-transition-property: none;
  -ms-transition-property: none;
  -o-transition-property: none;
  transition-property: none;
  -webkit-transition-duration: 0.3s;
  -moz-transition-duration: 0.3s;
  -ms-transition-duration: 0.3s;
  -o-transition-duration: 0.3s;
  transition-duration: 0.3s;
  -webkit-transition-timing-function: ease;
  -moz-transition-timing-function: ease;
  -ms-transition-timing-function: ease;
  -o-transition-timing-function: ease;
  transition-timing-function: ease;
  border: 1px solid #fff4f4;
  -moz-box-shadow: 0 0 3px #fff4f4;
  -webkit-box-shadow: 0 0 3px #fff4f4;
  box-shadow: 0 0 3px #fff4f4;
}
.form-line-error .form-error-message {
  margin: 0;
  position: absolute;
  color: #fff;
  display: inline-block;
  right: 0;
  font-size: 10px;
  position: absolute!important;
  box-shadow: none;
  top: 0px;
  line-height: 20px;
  color: #FFF;
  background: #ff3200;
  padding: 0px 5px;
  bottom: auto;
  min-width: 105px;
  -webkit-border-radius: 0;
  -moz-border-radius: 0;
  border-radius: 0;
}
.form-line-error .form-error-message img,
.form-line-error .form-error-message .form-error-arrow {
  display: none;
}
.ie-8 .form-all {
  margin-top: auto;
  margin-top: initial;
}
.ie-8 .form-all:before {
  display: none;
}
/* | */
@media screen and (max-width: 480px), screen and (max-device-width: 768px) and (orientation: portrait), screen and (max-device-width: 415px) and (orientation: landscape) {
  .testOne {
    letter-spacing: 0;
  }
  .jotform-form {
    padding: 12px 0 0 0;
  }
  .form-all {
    border: 0;
    width: 94%!important;
    max-width: initial;
  }
  .form-sub-label-container {
    width: 100%;
    margin: 0;
    margin-right: 0;
    float: left;
    -moz-box-sizing: border-box;
    -webkit-box-sizing: border-box;
    box-sizing: border-box;
  }
  span.form-sub-label-container + span.form-sub-label-container {
    margin-right: 0;
  }
  .form-sub-label {
    white-space: normal;
  }
  .form-address-table td,
  .form-address-table th {
    padding: 0 1px 10px;
  }
  .form-submit-button,
  .form-submit-print,
  .form-submit-reset {
    width: 100%;
    margin-left: 0!important;
  }
  div[id*=at_] {
    font-size: 14px;
    font-weight: 700;
    height: 8px;
    margin-top: 6px;
  }
  .showAutoCalendar {
    width: 20px;
  }
  img.form-image {
    max-width: 100%;
    height: auto;
  }
  .form-matrix-row-headers {
    width: 100%;
    word-break: break-all;
    min-width: 40px;
  }
  .form-collapse-table,
  .form-header-group {
    margin: 0;
  }
  .form-collapse-table {
    height: 100%;
    display: inline-block;
    width: 100%;
  }
  .form-collapse-hidden {
    display: none !important;
  }
  .form-input {
    width: 100%;
  }
  .form-label {
    width: 100% !important;
  }
  .form-label-left,
  .form-label-right {
    display: block;
    float: none;
    text-align: left;
    width: auto!important;
  }
  .form-line,
  .form-line.form-line-column {
    padding: 2% 5%;
    -moz-box-sizing: border-box;
    -webkit-box-sizing: border-box;
    box-sizing: border-box;
  }
  input[type=text],
  input[type=email],
  input[type=tel],
  textarea {
    width: 100%;
    -moz-box-sizing: border-box;
    -webkit-box-sizing: border-box;
    box-sizing: border-box;
    max-width: initial !important;
  }
  .form-dropdown,
  .form-textarea,
  .form-textbox {
    width: 100%!important;
    -moz-box-sizing: border-box;
    -webkit-box-sizing: border-box;
    box-sizing: border-box;
  }
  .form-input,
  .form-input-wide,
  .form-textarea,
  .form-textbox,
  .form-dropdown {
    max-width: initial!important;
  }
  .form-address-city,
  .form-address-line,
  .form-address-postal,
  .form-address-state,
  .form-address-table,
  .form-address-table .form-sub-label-container,
  .form-address-table select,
  .form-input {
    width: 100%;
  }
  div.form-header-group {
    padding: 12px 36px !important;
    padding-left: 5%!important;
    padding-right: 5%!important;
    margin: 0 0px 2% !important;
    -moz-box-sizing: border-box;
    -webkit-box-sizing: border-box;
    box-sizing: border-box;
  }
  div.form-header-group.hasImage img {
    max-width: 100%;
  }
  [data-type="control_button"] {
    margin-bottom: 0 !important;
  }
  [data-type=control_fullname] .form-sub-label-container {
    width: 48%;
  }
  [data-type=control_fullname] .form-sub-label-container:first-child {
    margin-right: 4%;
  }
  [data-type=control_phone] .form-sub-label-container {
    width: 65%;
  }
  [data-type=control_phone] .form-sub-label-container:first-child {
    width: 31%;
    margin-right: 4%;
  }
  [data-type=control_datetime] .form-sub-label-container + .form-sub-label-container,
  [data-type=control_datetime] .form-sub-label-container:first-child {
    width: 27.3%;
    margin-right: 6%;
  }
  [data-type=control_datetime] .form-sub-label-container + .form-sub-label-container + .form-sub-label-container {
    width: 33.3%;
    margin-right: 0;
  }
  [data-type=control_datetime] span + span + span > span:first-child {
    display: block;
    width: 100% !important;
  }
  [data-type=control_birthdate] .form-sub-label-container,
  [data-type=control_datetime] span + span + span > span:first-child + span + span,
  [data-type=control_time] .form-sub-label-container {
    width: 27.3%!important;
    margin-right: 6% !important;
  }
  [data-type=control_birthdate] .form-sub-label-container:last-child,
  [data-type=control_time] .form-sub-label-container:last-child {
    width: 33.3%!important;
    margin-right: 0 !important;
  }
  .form-pagebreak-back-container,
  .form-pagebreak-next-container {
    width: 50% !important;
  }
  .form-pagebreak-back,
  .form-pagebreak-next,
  .form-product-item.hover-product-item {
    width: 100%;
  }
  .form-pagebreak-back-container {
    padding: 0;
    text-align: right;
  }
  .form-pagebreak-next-container {
    padding: 0;
    text-align: left;
  }
  .form-pagebreak {
    margin: 0 auto;
  }
  .form-buttons-wrapper {
    margin: 0!important;
    margin-left: 0!important;
  }
  .form-buttons-wrapper button {
    width: 100%;
  }
  .form-buttons-wrapper .form-submit-print {
    margin: 0 !important;
  }
  table {
    width: 100%!important;
    max-width: initial!important;
  }
  table td + td {
    padding-left: 3%;
  }
  .form-checkbox-item,
  .form-radio-item {
    white-space: normal!important;
  }
  .form-checkbox-item input,
  .form-radio-item input {
    width: auto;
  }
  .form-collapse-table {
    margin: 0 5%;
    display: block;
    zoom: 1;
    width: auto;
  }
  .form-collapse-table:before,
  .form-collapse-table:after {
    display: table;
    content: '';
    line-height: 0;
  }
  .form-collapse-table:after {
    clear: both;
  }
  .fb-like-box {
    width: 98% !important;
  }
  .form-error-message {
    clear: both;
    bottom: -10px;
  }
  .date-separate,
  .phone-separate {
    display: none;
  }
  .custom-field-frame,
  .direct-embed-widgets,
  .signature-pad-wrapper {
    width: 100% !important;
  }
}
/* | */

/*PREFERENCES STYLE*/
    .form-all {
      font-family: Roboto, sans-serif;
    }
    .form-all .qq-upload-button,
    .form-all .form-submit-button,
    .form-all .form-submit-reset,
    .form-all .form-submit-print {
      font-family: Roboto, sans-serif;
    }
    .form-all .form-pagebreak-back-container,
    .form-all .form-pagebreak-next-container {
      font-family: Roboto, sans-serif;
    }
    .form-header-group {
      font-family: Roboto, sans-serif;
    }
    .form-label {
      font-family: Roboto, sans-serif;
    }
  
    .form-label.form-label-auto {
      
    display: block;
    float: none;
    text-align: left;
    width: 100%;
  
    }
  
    .form-line {
      margin-top: 5px;
      margin-bottom: 5px;
    }
  
    .form-all {
      max-width: 480px;
      width: 100%;
    }
  
    .form-label.form-label-left,
    .form-label.form-label-right,
    .form-label.form-label-left.form-label-auto,
    .form-label.form-label-right.form-label-auto {
      width: 150px;
    }
  
    .form-all {
      font-size: 14px
    }
    .form-all .qq-upload-button,
    .form-all .qq-upload-button,
    .form-all .form-submit-button,
    .form-all .form-submit-reset,
    .form-all .form-submit-print {
      font-size: 14px
    }
    .form-all .form-pagebreak-back-container,
    .form-all .form-pagebreak-next-container {
      font-size: 14px
    }
  
    .supernova .form-all, .form-all {
      background-color: #fff;
    }
  
    .form-all {
      color: #555;
    }
    .form-header-group .form-header {
      color: #555;
    }
    .form-header-group .form-subHeader {
      color: #555;
    }
    .form-label-top,
    .form-label-left,
    .form-label-right,
    .form-html,
    .form-checkbox-item label,
    .form-radio-item label,
    span.FITB .qb-checkbox-label,
    span.FITB .qb-radiobox-label,
    span.FITB .form-radio label,
    span.FITB .form-checkbox label,
    [data-blotid][data-type=checkbox] [data-labelid],
    [data-blotid][data-type=radiobox] [data-labelid],
    span.FITB-inptCont[data-type=checkbox] label,
    span.FITB-inptCont[data-type=radiobox] label {
      color: #555;
    }
    .form-sub-label {
      color: #6f6f6f;
    }
  
    .supernova {
      background-color: rgb(255, 255, 255);
    }
    .supernova body {
      background: transparent;
    }
  
    .form-textbox,
    .form-textarea,
    .form-dropdown,
    .form-radio-other-input,
    .form-checkbox-other-input,
    .form-captcha input,
    .form-spinner input {
      background-color: #fff;
    }
  
    .supernova {
      background-image: none;
    }
    #stage {
      background-image: none;
    }
  
    .form-all {
      background-image: none;
    }
  
    .form-all {
      position: relative;
    }
    .form-all:before {
      content: "";
      background-image: url("https://www.jotform.com/uploads/WEBSITEFLIX/form_files/michael-melnik-keynote-safety-speaker-.63eac1f0083128.64610179.jpg");
      display: inline-block;
      height: 212.65822784810126px;
      position: absolute;
      background-size: 480px 212px;
      background-repeat: no-repeat;
      width: 100%;
    }
    .form-all {
      margin-top: 222px !important;
    }
    .form-all:before {
      top: -222px;
      background-position: top center;
      left: 0;
    }
           
  .ie-8 .form-all:before { display: none; }
  .ie-8 {
    margin-top: auto;
    margin-top: initial;
  }
  
  /*PREFERENCES STYLE*//*__INSPECT_SEPERATOR__*/
/*---------------------
Theme: Generic Theme
Author: Elton Cris - idarktech@jotform.com
www.jotform.com
----------------------*/
.form-all {
    -moz-box-sizing : border-box;
    -webkit-box-sizing : border-box;
    box-sizing : border-box;
    -moz-box-shadow : 0 1px 4px rgba(0, 0, 0, .25);
    -webkit-box-shadow : 0 1px 4px rgba(0, 0, 0, .25);
    box-shadow : 0 1px 4px rgba(0, 0, 0, .25) !important;
}

[data-type="control_head"] {
    padding-bottom : 20px;
}

/*responsive fields*/
[data-type="control_textbox"] .form-textbox, 
[data-type="control_fullname"] .form-textbox,
[data-type="control_email"] .form-textbox,
[data-type="control_textarea"] .form-textarea, 
[data-type="control_dropdown"] .form-dropdown {
    width : 100% !important;
    max-width : none !important;
}

.form-textbox, .form-textarea, .form-dropdown {
    max-width : none !important;
    box-shadow : none;
    outline : none;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
    -moz-box-sizing : border-box;
    font-family : inherit;
    padding : 8px;
    transition : .3s ease-in-out;
    box-shadow : 0 1px 2px rgba(0, 0, 0, .15) inset;
}

.form-textarea-limit>span {
    display : block;
}

[data-type="control_dropdown"] .form-input, 
[data-type="control_dropdown"] .form-input-wide {
    width : 100%;
}

/*input focus*/
.form-line-active input:focus, .form-line-active textarea:focus, .form-line-active select:focus {
    outline : 0;
    border-color : 1px solid rgba(82, 168, 236, 0.8) !important;
    box-shadow : inset 0 1px 3px rgba(0, 0, 0, 0.1),0 0 8px rgba(82, 168, 236, 0.6);
}

/*reset error*/
.form-line-error {
    box-shadow : none;
}

/*input error*/
.form-line-error input:not(#coupon-input), .form-line-error textarea, .form-line-error select, .form-line-error .form-validation-error {
    border : 1px solid #e15353 !important;
    box-shadow : none !important;
}

.form-line-active {
    color : inherit !important;
}

/*responsive content -wide or shrink*/
.form-label {
    width : 35% !important;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
    -moz-box-sizing : border-box;
}

.form-label-top {
    width : 100% !important;
}

.form-line {
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
    -moz-box-sizing : border-box;
    width : 100%;
}

.form-checkbox-other-input {
    width : 80% !important;
}

.form-input {
    width : 65% !important;
    max-width : none !important;
}

.form-input-wide {
    max-width : none !important;
    display : inline-block;
    width : 100%;
}

/*single fields with sublabels*/
[data-type="control_textbox"] .form-input-wide .form-sub-label-container, 
[data-type="control_fullname"] .form-input-wide .form-sub-label-container,
[data-type="control_email"] .form-input-wide .form-sub-label-container,
[data-type="control_textarea"] .form-input-wide .form-sub-label-container, 
[data-type="control_dropdown"] .form-input-wide .form-sub-label-container,
[data-type="control_textbox"] .form-input .form-sub-label-container, 
[data-type="control_fullname"] .form-input .form-sub-label-container,
[data-type="control_email"] .form-input .form-sub-label-container,
[data-type="control_textarea"] .form-input .form-sub-label-container, 
[data-type="control_dropdown"] .form-input .form-sub-label-container {
    width : 100%;
    max-width : none !important;
}

[data-type="control_dropdown"] .form-input-wide {
    width : 100%;
}

/*responsive full name*/
[data-type="control_fullname"] .form-sub-label-container {
    width : 50% !important;
    margin : 0 !important;
    float : left;
    box-sizing : border-box;
}

[data-type="control_fullname"] .form-label + div .form-sub-label-container {
    display : inline-block;
    padding-right : 5px;
}

[data-type="control_fullname"] .form-label + div .form-sub-label-container + .form-sub-label-container {
    margin-right : 0;
    padding-right : 0;
    padding-left : 5px;
}

[data-type="control_fullname"] .form-label + div .form-sub-label-container + .form-sub-label-container {
    margin-right : 0;
    padding-right : 0;
    padding-left : 5px;
}

[data-type="control_fullname"] .form-label + div .form-sub-label-container + .form-sub-label-container + .form-sub-label-container {
    padding-left : 0;
    padding-right : 5px;
}

[data-type="control_fullname"] .form-label + div .form-sub-label-container + .form-sub-label-container + .form-sub-label-container + .form-sub-label-container {
    padding-left : 5px;
    padding-right : 0;
}

[data-type="control_fullname"] .form-label + div .form-sub-label-container + .form-sub-label-container  + .form-sub-label-container + .form-sub-label-container + .form-sub-label-container {
    padding-right : 5px;
    padding-left : 0;
}

#sublabel_prefix, #sublabel_first, #sublabel_middle {
    /*margin-bottom : 10px;
    */;
}

/*remove sepatators on date and phone*/
.phone-separate, .date-separate {
    display : none;
}

/*responsive phone fields*/
[data-type="control_phone"] input[name$="[area]"] {
    width : 100%;
}

[data-type="control_phone"] input[name$="[phone]"] {
    width : 100%;
}

[data-type="control_phone"] input[name$="[full]"] {
    width : 100%;
}

[data-type="control_phone"] .form-sub-label-container {
    width : 40%;
    float : left;
    box-sizing : border-box;
    margin-right : 0;
    padding-right : 12px;
}

/* responsive date time field */
[data-type="control_datetime"] .form-textbox,
[data-type="control_datetime"] .form-dropdown {
    width : 100%;
}

[data-type="control_datetime"] .form-sub-label-container {
    width : 28%;
    padding-left : 4px;
    box-sizing : border-box;
    margin-right : 0;
}

[data-type="control_datetime"] .form-sub-label-container:first-child {
    padding-left : 0;
}

[data-type="control_datetime"] .form-sub-label-container:first-child + .form-sub-label-container + .form-sub-label-container {
    padding-right : 0;
}

[data-type="control_datetime"] .form-sub-label-container:last-child {
    width : auto !important;
}

.allowTime-container .form-sub-label-container:last-child {
    width : 20% !important;
}

span.allowTime-container {
    width : 80%;
    padding-top : 14px;
}

.allowTime-container span.form-sub-label-container {
    width : 35%;
}

span.allowTime-container .form-dropdown {
    width : 100%;
}

span.allowTime-container > span:first-child {
    display : none;
}

span.allowTime-container > span:first-child + span {
    padding-left : 0;
}

.showAutoCalendar + label {
    display : none;
}

span.allowTime-container + span {
    padding-top : 14px;
}

/*calendar lite mode*/
[data-type="control_datetime"] div[style*="none"] + .form-sub-label-container {
    width : 84%;
    padding-left : 0;
}

/*responsive phone field*/
[data-type="control_phone"] .form-sub-label-container + .form-sub-label-container {
    width : 60%;
    margin-right : 0;
    padding-right : 0;
    padding-left : 12px;
}

/*responsive full address fields*/
.form-address-city, .form-address-line, .form-address-postal, 
.form-address-state, .form-address-table, 
.form-address-table .form-sub-label-container, .form-address-table select {
    width : 100%;
    max-width : 100%;
}

[data-type="control_address"] input[name$="[city]"],
[data-type="control_address"] input[name$="[postal]"] {
    width : 90% !important;
}

[data-type="control_address"] input[name$="[area]"] {
    width : 60%;
}

/*reset submit button*/
[data-type="control_button"] {
    background : transparent !important;
}

.form-submit-button,
.form-submit-reset,
.form-submit-print {
    outline : none;
}

/*remove other checkbox*/
.form-checkbox-other, 
.form-radio-other {
    visibility : hidden !important;
}

/*shruken fields*/
.form-line-column {
    width : 50%;
}

.form-line-column .form-label-top {
    width : 100% !important;
}

/*fix form builder display*/
div#stage.form-all {
    max-width : none !important;
    margin-right : 0;
}

div#stage .form-input {
    width : 64% !important;
}

/*remove first pagebreak back button*/
.form-all .page-section:first-child .form-pagebreak .form-pagebreak-back-container {
    display : none !important;
}

/* responsive pagebreak */
.form-pagebreak-back-container {
    width : 50% !important;
    text-align : left;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
    float : left;
}

.form-pagebreak-next-container {
    width : 50% !important;
    text-align : right;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
    float : left;
}

/* radio-checkbox button make border 1px */
.form-radio-item:not(#foo) label:after,
.form-radio-item:not(#foo) label:before {
    border-radius : 50%;
}

.form-checkbox-item:not(#foo) label:after,
.form-checkbox-item:not(#foo) label:before {
    border-radius : 0;
}

.form-radio-item:not(#foo) label:before,
.form-checkbox-item:not(#foo) label:before {
    border-width : 1px;
}

/*responsive credit card on payment fields*/
table td + td {
    padding-left : 0;
}

.form-address-table {
    width : 100%;
}

[data-type="control_stripe"] .form-address-table,
[data-type="control_stripe"] .form-address-table .form-textbox,
[data-type="control_authnet"] .form-address-table,
[data-type="control_authnet"] .form-address-table .form-textbox,
#creditCardTable.form-address-table,
#creditCardTable.form-address-table .form-textbox {
    max-width : none;
}

[data-type="control_stripe"] .form-address-table td:last-child .form-sub-label-container,
[data-type="control_authnet"] .form-address-table td:last-child .form-sub-label-container,
#creditCardTable.form-address-table td:last-child .form-sub-label-container {
    margin-left : 0;
    white-space : normal;
}

[data-type="control_stripe"] .form-address-table td .form-sub-label-container,
[data-type="control_authnet"] .form-address-table td .form-sub-label-container,
#creditCardTable.form-address-table td .form-sub-label-container {
    width : 100%;
}

[data-type="control_stripe"] .form-address-table .form-textbox,
[data-type="control_stripe"] .form-address-table .form-dropdown,
[data-type="control_authnet"] .form-address-table .form-textbox,
[data-type="control_authnet"] .form-address-table .form-dropdown,
#creditCardTable.form-address-table .form-textbox,
#creditCardTable.form-address-table .form-dropdown {
    width : 100%;
    visibility : visible;
}

[data-type="control_stripe"] .form-address-table tbody > tr:first-child + tr td:first-child span,
[data-type="control_authnet"] .form-address-table tbody > tr:first-child + tr td:first-child span,
#creditCardTable.form-address-table tbody > tr:first-child + tr td:first-child span {
    margin : 0;
    padding-right : 6px;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
}

[data-type="control_stripe"] .form-address-table tbody > tr:first-child + tr td:first-child + td span,
[data-type="control_authnet"] .form-address-table tbody > tr:first-child + tr td:first-child + td span,
#creditCardTable.form-address-table tbody > tr:first-child + tr td:first-child + td span {
    margin : 0;
    padding-left : 6px;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
}

[data-type="control_stripe"] .form-address-table tbody > tr:first-child + tr +tr td:first-child span,
[data-type="control_stripe"] .form-address-table tbody > tr:first-child + tr +tr+tr td:first-child span,
[data-type="control_authnet"] .form-address-table tbody > tr:first-child + tr +tr td:first-child span,
[data-type="control_authnet"] .form-address-table tbody > tr:first-child + tr +tr+tr td:first-child span,
#creditCardTable.form-address-table tbody > tr:first-child + tr +tr td:first-child span,
#creditCardTable.form-address-table tbody > tr:first-child + tr +tr+tr td:first-child span {
    margin : 0;
    padding-right : 6px;
    width : 50% !important;
    visibility : hidden;
    float : left;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
}

[data-type="control_stripe"] .form-address-table tbody > tr:first-child + tr +tr td:first-child span + span,
[data-type="control_stripe"] .form-address-table tbody > tr:first-child + tr +tr+tr td:first-child span + span,
[data-type="control_authnet"] .form-address-table tbody > tr:first-child + tr +tr td:first-child span + span,
[data-type="control_authnet"] .form-address-table tbody > tr:first-child + tr +tr+tr td:first-child span + span,
#creditCardTable.form-address-table tbody > tr:first-child + tr +tr td:first-child span + span,
#creditCardTable.form-address-table tbody > tr:first-child + tr +tr+tr td:first-child span + span {
    margin : 0;
    padding-top : 0 !important;
    padding-right : 0;
    padding-left : 6px;
    width : 50% !important;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
}

.cc_ccv {
    width : 100% !important;
}

[data-type="control_stripe"] .form-address-table .form-sub-label,
[data-type="control_authnet"] .form-address-table .form-sub-label,
#creditCardTable.form-address-table .form-sub-label {
    visibility : visible;
}

/*cc fix city state, country */
[data-type="control_stripe"] .form-address-table td[width="50%"]>span:first-child,
[data-type="control_authnet"] .form-address-table td[width="50%"]>span:first-child,
#creditCardTable.form-address-table td[width="50%"]>span:first-child {
    box-sizing : border-box;
    padding-right : 7px;
}

[data-type="control_stripe"] .form-address-table td[width="50%"] + td >span:first-child,
[data-type="control_authnet"] .form-address-table td[width="50%"] + td >span:first-child,
#creditCardTable.form-address-table td[width="50%"] + td >span:first-child {
    box-sizing : border-box;
    padding-left : 7px;
}

[data-type="control_stripe"] .form-address-table td[width="50%"] + td[width="50%"] >span:first-child,
[data-type="control_authnet"] .form-address-table td[width="50%"] + td[width="50%"] >span:first-child,
#creditCardTable.form-address-table td[width="50%"] + td[width="50%"] >span:first-child {
    box-sizing : border-box;
    padding-right : 0;
}

.hover-product-item:hover {
    color : inherit;
}

/*fix for braintree cc styling*/
[data-type="control_braintree"] .form-sub-label-container {
    width : 100% !important;
    padding : 4px;
    box-sizing : border-box;
}

[data-type="control_braintree"] .form-textbox {
    width : 100%;
}

.braintree-hosted-fields {
    width : 100% !important;
    box-sizing : border-box;
    min-height : 28px;
}

/*remove bottom spacing on CC section*/
#creditCardTable.form-address-table tbody tr + tr + tr td,
[data-type="control_stripe"] .form-address-table tbody tr + tr + tr td,
[data-type="control_authnet"] .form-address-table tbody tr + tr + tr td {
    padding-bottom : 0;
}

@media screen and (max-device-width:768px){
    .form-all {
        margin : 0 auto !important;
        width : 100% !important;
    }

    [data-type=control_fullname] .form-sub-label-container:first-child {
        margin-right : 0;
    }

}

@media screen and (max-width:480px){
    .jotform-form {
        padding : 0;
    }

    .form-input {
        width : 100% !important;
    }

    .form-label {
        width : 100% !important;
        float : none !important;
    }

    .form-line-column {
        width : 100% !important;
    }

    div.form-header-group {
        margin : 0 !important;
        padding : 24px 20px !important;
    }

    [data-type="control_datetime"] .form-sub-label-container {
        float : left;
    }

    [data-type=control_fullname] .form-sub-label-container:first-child {
        margin-right : 0;
    }

}

/*----fix the new awful error message----*/
li.form-line-error .form-error-message img {
    position: static !important;
    margin-top: 0;
    left: 0;
    top: 0;
    vertical-align: middle;
    padding: 2px 0;
}
li.form-line-error .form-error-message {
    padding: 2px 6px;
}
    /* Injected CSS Code */
</style>

<link type="text/css" rel="stylesheet" href="https://cdn02.jotfor.ms/css/styles/buttons/form-submit-button-black_blue.css?3.3.39252"/>
<form class="jotform-form" action="https://submit.jotform.com/submit/230436531889160/" method="post" name="form_230436531889160" id="230436531889160" accept-charset="utf-8" autocomplete="off"><input type="hidden" name="formID" value="230436531889160" /><input type="hidden" id="JWTContainer" value="" /><input type="hidden" id="cardinalOrderNumber" value="" />
  <div role="main" class="form-all">
    <link type="text/css" rel="stylesheet" media="all" href="https://cdn.jotfor.ms/wizards/languageWizard/custom-dropdown/css/lang-dd.css?3.3.39252" />
    <div class="cont"><input type="text" id="input_language" name="input_language" style="display:none" />
      <div class="language-dd" id="langDd" style="display:none">
        <div class="dd-placeholder lang-emp">Language</div>
        <ul class="lang-list dn" id="langList">
          <li data-lang="en" class="en">English (US)</li>
        </ul>
      </div>
    </div>
    <script type="text/javascript" src="https://cdn.jotfor.ms/js/formTranslation.v2.js?3.3.39252"></script>
    <ul class="form-section page-section">
      <li class="form-line" data-type="control_text" id="id_23">
        <div id="cid_23" class="form-input-wide">
          <div id="text_23" class="form-html" data-component="text" tabindex="0">
            <p>Bring <strong>Keynote Michael Melnik</strong> to your facility to deliver The Energized Approach for Creating a Safe, Healthy and Productive Workplace Target Audience: Managers, Supervisors, leads and anyone with a responsibility for the safety of employees.</p>
            <p>For pricing and availability please send us an email at <a href="mailto:info@charliemorecraft.com" target="_blank" rel="nofollow">info@charliemorecraft.com</a> or fill out the form below.</p>
            <p>Contact Details: +1 (561) 997-1120<br />Toll Free: (800) 783-0796<br />Email: <a href="mailto:info@charliemorecraft.com" target="_blank" rel="nofollow">info@charliemorecraft.com</a> <br />Website: <a href="https://www.charliemorecraft.com/charlies-speakers-team-michael-melnik-m-s-o-t-r/" target="_blank" rel="nofollow">https://www.charliemorecraft.com/charlies-speakers-team-michael-melnik-m-s-o-t-r/</a></p>
            <p> </p>
          </div>
        </div>
      </li>
      <li class="form-line jf-required" data-type="control_textbox" id="id_20"><label class="form-label form-label-top form-label-auto" id="label_20" for="input_20"> Company<span class="form-required">*</span> </label>
        <div id="cid_20" class="form-input-wide jf-required"> <input type="text" id="input_20" name="q20_company" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="20" value="" data-component="textbox" aria-labelledby="label_20" required="" /> </div>
      </li>
      <li class="form-line jf-required" data-type="control_dropdown" id="id_26"><label class="form-label form-label-top form-label-auto" id="label_26" for="input_26"> Keynote Safety Speaker<span class="form-required">*</span> </label>
        <div id="cid_26" class="form-input-wide jf-required"> <select class="form-dropdown validate[required]" id="input_26" name="q26_keynoteSafety" style="width:150px" data-component="dropdown" required="" aria-label="Keynote Safety Speaker">
            <option value="">Please Select</option>
            <option selected="" value="Michael Melnik">Michael Melnik</option>
            <option value="Charlie Morecraft">Charlie Morecraft</option>
          </select> </div>
      </li>
      <li class="form-line form-line-column form-col-1 jf-required" data-type="control_textbox" id="id_3"><label class="form-label form-label-top" id="label_3" for="input_3"> First Name<span class="form-required">*</span> </label>
        <div id="cid_3" class="form-input-wide jf-required"> <input type="text" id="input_3" name="q3_firstName" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="23" value="" placeholder=" " data-component="textbox" aria-labelledby="label_3" required="" /> </div>
      </li>
      <li class="form-line form-line-column form-col-2 jf-required" data-type="control_textbox" id="id_9"><label class="form-label form-label-top" id="label_9" for="input_9"> Last Name<span class="form-required">*</span> </label>
        <div id="cid_9" class="form-input-wide jf-required"> <input type="text" id="input_9" name="q9_lastName" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="25" value="" placeholder=" " data-component="textbox" aria-labelledby="label_9" required="" /> </div>
      </li>
      <li class="form-line form-line-column form-col-1 form-line-column-clear jf-required" data-type="control_textbox" id="id_10"><label class="form-label form-label-top" id="label_10" for="input_10"> E-mail<span class="form-required">*</span> </label>
        <div id="cid_10" class="form-input-wide jf-required"> <input type="text" id="input_10" name="q10_email10" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="23" value="" placeholder=" " data-component="textbox" aria-labelledby="label_10" required="" /> </div>
      </li>
      <li class="form-line form-line-column form-col-2 jf-required" data-type="control_textbox" id="id_11"><label class="form-label form-label-top" id="label_11" for="input_11"> Phone<span class="form-required">*</span> </label>
        <div id="cid_11" class="form-input-wide jf-required"> <input type="text" id="input_11" name="q11_phone" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="25" value="" placeholder=" " data-component="textbox" aria-labelledby="label_11" required="" /> </div>
      </li>
      <li class="form-line jf-required" data-type="control_textarea" id="id_25"><label class="form-label form-label-top form-label-auto" id="label_25" for="input_25"> Event Date(s) and/or Location(s)<span class="form-required">*</span> </label>
        <div id="cid_25" class="form-input-wide jf-required"> <textarea id="input_25" class="form-textarea validate[required]" name="q25_eventDates" cols="40" rows="6" data-component="textarea" required="" aria-labelledby="label_25"></textarea> </div>
      </li>
      <li class="form-line" data-type="control_textarea" id="id_19"><label class="form-label form-label-top form-label-auto" id="label_19" for="input_19"> Other Details </label>
        <div id="cid_19" class="form-input-wide"> <textarea id="input_19" class="form-textarea" name="q19_otherDetails" cols="70" rows="6" data-component="textarea" aria-labelledby="label_19"></textarea> </div>
      </li>
      <li class="form-line jf-required" data-type="control_captcha" id="id_21"><label class="form-label form-label-top form-label-auto" id="label_21" for="input_21"> Please verify that you are human<span class="form-required">*</span> </label>
        <div id="cid_21" class="form-input-wide jf-required">
          <section data-wrapper-react="true">
            <div id="recaptcha_input_21" data-component="recaptcha" data-callback="recaptchaCallbackinput_21" data-expired-callback="recaptchaExpiredCallbackinput_21"></div><input type="hidden" id="input_21" class="hidden validate[required]" name="recaptcha_visible" required="" />
            <script type="text/javascript" src="https://www.google.com/recaptcha/api.js?render=explicit&amp;onload=recaptchaLoadedinput_21"></script>
            <script type="text/javascript">
              var recaptchaLoadedinput_21 = function()
              {
                window.grecaptcha.render($("recaptcha_input_21"),
                {
                  sitekey: '6LdU3CgUAAAAAB0nnFM3M3T0sy707slYYU51RroJ',
                });
                var grecaptchaBadge = document.querySelector('.grecaptcha-badge');
                if (grecaptchaBadge)
                {
                  grecaptchaBadge.style.boxShadow = 'gray 0px 0px 2px';
                }
              };

              /**
               * Called when the reCaptcha verifies the user is human
               * For invisible reCaptcha;
               *   Submit event is stopped after validations and recaptcha is executed.
               *   If a challenge is not displayed, this will be called right after grecaptcha.execute()
               *   If a challenge is displayed, this will be called when the challenge is solved successfully
               *   Submit is triggered to actually submit the form since it is stopped before.
               */
              var recaptchaCallbackinput_21 = function()
              {
                var isInvisibleReCaptcha = false;
                var hiddenInput = $("input_21");
                hiddenInput.setValue(1);
                if (!isInvisibleReCaptcha)
                {
                  if (hiddenInput.validateInput)
                  {
                    hiddenInput.validateInput();
                  }
                }
                else
                {
                  triggerSubmit(hiddenInput.form)
                }

                function triggerSubmit(formElement)
                {
                  var button = formElement.ownerDocument.createElement('input');
                  button.style.display = 'none';
                  button.type = 'submit';
                  formElement.appendChild(button).click();
                  formElement.removeChild(button);
                }
              }

              // not really required for invisible recaptcha
              var recaptchaExpiredCallbackinput_21 = function()
              {
                var hiddenInput = $("input_21");
                hiddenInput.writeAttribute("value", false);
                if (hiddenInput.validateInput)
                {
                  hiddenInput.validateInput();
                }
              }
            </script>
          </section>
        </div>
      </li>
      <li class="form-line" data-type="control_button" id="id_8">
        <div id="cid_8" class="form-input-wide">
          <div data-align="center" class="form-buttons-wrapper form-buttons-center   jsTest-button-wrapperField"><button id="input_8" type="submit" class="form-submit-button form-submit-button-black_blue submit-button jf-form-buttons jsTest-submitField" data-component="button" data-content="">Submit</button></div>
        </div>
      </li>
      <li style="display:none">Should be Empty: <input type="text" name="website" value="" /></li>
    </ul>
  </div>
  <script>
    JotForm.showJotFormPowered = "0";
  </script>
  <script>
    JotForm.poweredByText = "Powered by Jotform";
  </script><input type="hidden" class="simple_spc" id="simple_spc" name="simple_spc" value="230436531889160" />
  <script type="text/javascript">
    var all_spc = document.querySelectorAll("form[id='230436531889160'] .si" + "mple" + "_spc");
    for (var i = 0; i < all_spc.length; i++)
    {
      all_spc[i].value = "230436531889160-230436531889160";
    }
  </script>
</form><script type="text/javascript">JotForm.ownerView=true;</script>
<p>The post <a href="https://www.charlieonsafety.com/charlies-speakers-team-michael-melnik-m-s-o-t-r/">Charlie&#8217;s Speakers Team &#8211; Michael Melnik M.S., O.T.R</a> appeared first on <a href="https://www.charlieonsafety.com">Charlie Morecraft</a>.</p>
]]></content:encoded>
					
		
		
			</item>
		<item>
		<title>Charlie&#8217;s Speakers Team &#8211; Astronaut Mike Mullane</title>
		<link>https://www.charlieonsafety.com/charlies-speakers-team-astronaut-mike-mullane/</link>
					<comments>https://www.charlieonsafety.com/charlies-speakers-team-astronaut-mike-mullane/#respond</comments>
		
		<dc:creator><![CDATA[Charlie Morecraft]]></dc:creator>
		<pubDate>Mon, 21 Jun 2021 17:14:24 +0000</pubDate>
				<category><![CDATA[Speaker's Team]]></category>
		<category><![CDATA[Speaker's team]]></category>
		<guid isPermaLink="false">https://www.charlieonsafety.com/?p=2240</guid>

					<description><![CDATA[<p>We are proud to have Colonel Mullane as part of our speaker&#8217;s team! Colonel Mullane Biography Mullane was born September 10, 1945 in Wichita Falls, Texas but spent much of his youth in Albuquerque, New Mexico, where he currently resides. Upon his graduation from West Point in 1967, he was commissioned in the United States &#8230; </p>
<p>The post <a href="https://www.charlieonsafety.com/charlies-speakers-team-astronaut-mike-mullane/">Charlie&#8217;s Speakers Team &#8211; Astronaut Mike Mullane</a> appeared first on <a href="https://www.charlieonsafety.com">Charlie Morecraft</a>.</p>
]]></description>
										<content:encoded><![CDATA[<h4>We are proud to have Colonel Mullane as part of our speaker&#8217;s team!</h4>
<h3>Colonel Mullane Biography</h3>
<p>Mullane was born September 10, 1945 in Wichita Falls, Texas but spent much of his youth in Albuquerque, New Mexico, where he currently resides. Upon his graduation from West Point in 1967, he was commissioned in the United States Air Force. As a Weapon Systems Operator aboard RF-4C Phantom aircraft, he completed 134 combat missions in Vietnam. He holds a Master&#8217;s of Science Degree in Aeronautical Engineering from the Air Force Institute of Technology and is also a graduate of the Air Force Flight Test Engineer School at Edwards Air Force Base, California.</p>
<p>Mullane was selected as a Mission Specialist in 1978 in the first group of Space Shuttle Astronauts. He completed three space missions aboard the Shuttles Discovery (STS-41D) and Atlantis (STS-27 &amp; 36) before retiring from NASA and the Air Force in 1990.</p>
<p>Mullane has been inducted into the International Space Hall of Fame and is the recipient of many awards, including the Air Force Distinguished Flying Cross, Legion of Merit and the NASA Space Flight Medal.</p>
<p>Since his retirement from NASA, Colonel Mullane has written an award-winning children&#8217;s book, Liftoff! An Astronaut&#8217;s Dream, and a popular space-fact book, Do Your Ears Pop In Space? His memoir, Riding Rockets: The Outrageous Tales of a Space Shuttle Astronaut, has been reviewed in the New York Times and on the Jon Stewart Daily Show. It has also been featured on Barnes and Noble’s 2010 recommended summer reading list.</p>
<p>Mullane has held a lifelong passion for mountain climbing. Since age 60 he has summited Africa’s highest peak, Mt. Kilimanjaro, as well as Mt. Rainier in Washington State and forty of Colorado’s 14,000 ft. peaks.</p>
<p>Colonel Mullane has established himself as an acclaimed professional speaker on the topics of teamwork, leadership and safety. He has educated, entertained, inspired and thrilled tens of thousands of people from every walk of business and government with his incredibly unique programs.</p>
<p><strong>Qualifications</strong></p>
<p>Colonel Mullane has established himself as an acclaimed professional speaker on the topics of teamwork, leadership and safety.  He has educated, entertained, inspired and thrilled tens of thousands of people from every walk of business and government with his incredibly unique programs. Mullane has been inducted into the International Space Hall of Fame and is the recipient of many awards, including the Air Force Distinguished Flying Cross, Legion of Merit and the NASA Space Flight Medal.</p>
<p><strong>Videos</strong></p>
<p>Mullane offers a video contains a 30-minute discussion on the dangers of normalizing deviances from safety best practices and how to protect yourself and team from falling victim to this normalizing phenomenon. Mullane’s comments are lavishly supported with rarely seen NASA videos and photos making it extremely easy for any audience (including non-technical audiences) to follow and understand the message.  You do not need to be a rocket scientist to be thoroughly educated, inspired, and motivated by the contents of this video!</p>
<p>Buy this safety video program at <a href="https://www.charliemorecraft.com/product/stopping-normalization-of-deviance-a-safety-program/">https://www.charliemorecraft.com/product/stopping-normalization-of-deviance-a-safety-program/</a></p>
<p><a href="https://www.charliemorecraft.com/product/stopping-normalization-of-deviance-a-safety-program/"><img decoding="async" class="alignnone wp-image-2580" src="https://www.charliemorecraft.com/wp-content/uploads/2021/08/astronaut.png" alt="Astronaut Mike Mullane" width="241" height="136" /></a></p>
<h4>To inquire about Mullane&#8217;s presentations please call our office at (800) 783-0796, contact us by email at <a href="mailto:info@charliemorecraft.com">info@charliemorecraft.com</a> or fill out the form below.</h4>
<h3 style="margin-top: 40px;">Colonel Mullane &#8211; Presentation Inquiry</h3>
<script src="https://cdn03.jotfor.ms/static/prototype.forms.js?3.3.39252" type="text/javascript"></script>
<script src="https://cdn01.jotfor.ms/static/jotform.forms.js?3.3.39252" type="text/javascript"></script>
<script type="text/javascript">	JotForm.newDefaultTheme = false;
	JotForm.extendsNewTheme = false;
	JotForm.singleProduct = false;
	JotForm.newPaymentUIForNewCreatedForms = false;
	JotForm.highlightInputs = false;

	JotForm.init(function(){
	/*INIT-START*/
if (window.JotForm && JotForm.accessible) $('input_20').setAttribute('tabindex',0);
if (window.JotForm && JotForm.accessible) $('input_3').setAttribute('tabindex',0);
if (window.JotForm && JotForm.accessible) $('input_9').setAttribute('tabindex',0);
if (window.JotForm && JotForm.accessible) $('input_10').setAttribute('tabindex',0);
if (window.JotForm && JotForm.accessible) $('input_11').setAttribute('tabindex',0);
if (window.JotForm && JotForm.accessible) $('input_25').setAttribute('tabindex',0);
if (window.JotForm && JotForm.accessible) $('input_19').setAttribute('tabindex',0);
      JotForm.alterTexts({"ageVerificationError":"You must be older than {minAge} years old to submit this form.","alphabetic":"This field can only contain letters","alphanumeric":"This field can only contain letters and numbers.","appointmentSelected":"You’ve selected {time} on {date}","ccDonationMinLimitError":"Minimum amount is {minAmount} {currency}","ccInvalidCVC":"CVC number is invalid.","ccInvalidExpireDate":"Expire date is invalid.","ccInvalidExpireMonth":"Expiration month is invalid.","ccInvalidExpireYear":"Expiration year is invalid.","ccInvalidNumber":"Credit Card Number is invalid.","ccMissingDetails":"Please fill up the credit card details.","ccMissingDonation":"Please enter numeric values for donation amount.","ccMissingProduct":"Please select at least one product.","characterLimitError":"Too many Characters.  The limit is","characterMinLimitError":"Too few characters. The minimum is","confirmClearForm":"Are you sure you want to clear the form","confirmEmail":"E-mail does not match","currency":"This field can only contain currency values.","cyrillic":"This field can only contain cyrillic characters","dateInvalid":"This date is not valid. The date format is {format}","dateInvalidSeparate":"This date is not valid. Enter a valid {element}.","dateLimited":"This date is unavailable.","disallowDecimals":"Please enter a whole number.","doneButton":"Done","doneMessage":"Well done! All errors are fixed.","dragAndDropFilesHere_infoMessage":"Drag and drop files here","email":"Enter a valid e-mail address","fillMask":"Field value must fill mask.","freeEmailError":"Free email accounts are not allowed","generalError":"There are errors on the form. Please fix them before continuing.","generalPageError":"There are errors on this page. Please fix them before continuing.","geoNotAvailableDesc":"Location provider not available. Please enter the address manually.","geoNotAvailableTitle":"Position Unavailable","geoPermissionDesc":"Check your browser's privacy settings.","geoPermissionTitle":"Permission Denied","geoTimeoutDesc":"Please check your internet connection and try again.","geoTimeoutTitle":"Timeout","gradingScoreError":"Score total should only be less than or equal to","incompleteFields":"There are incomplete required fields. Please complete them.","inputCarretErrorA":"Input should not be less than the minimum value:","inputCarretErrorB":"Input should not be greater than the maximum value:","justSoldOut":"Just Sold Out","lessThan":"Your score should be less than or equal to","maxDigitsError":"The maximum digits allowed is","maxFileSize_infoMessage":"Max. file size","maxSelectionsError":"The maximum number of selections allowed is ","minCharactersError":"The number of characters should not be less than the minimum value:","minSelectionsError":"The minimum required number of selections is ","multipleError":"There are {count} errors in this page. Please correct them before moving on.","multipleFileUploads_emptyError":"{file} is empty, please select files again without it.","multipleFileUploads_fileLimitError":"Only {fileLimit} file uploads allowed.","multipleFileUploads_minSizeError":"{file} is too small, minimum file size is {minSizeLimit}.","multipleFileUploads_onLeave":"The files are being uploaded, if you leave now the upload will be cancelled.","multipleFileUploads_sizeError":"{file} is too large, maximum file size is {sizeLimit}.","multipleFileUploads_typeError":"{file} has invalid extension. Only {extensions} are allowed.","multipleFileUploads_uploadFailed":"File upload failed, please remove it and upload the file again.","noSlotsAvailable":"No slots available","notEnoughStock":"Not enough stock for the current selection","notEnoughStock_remainedItems":"Not enough stock for the current selection ({count} items left)","noUploadExtensions":"File has no extension file type (e.g. .txt, .png, .jpeg)","numeric":"This field can only contain numeric values","oneError":"There is {count} error in this page. Please correct it before moving on.","pastDatesDisallowed":"Date must not be in the past.","pleaseWait":"Please wait...","required":"This field is required.","requiredLegend":"All fields marked with * are required and must be filled.","requireEveryCell":"Every cell is required.","requireEveryRow":"Every row is required.","requireOne":"At least one field required.","restrictedDomain":"This domain is not allowed","seeErrorsButton":"See Errors","selectionSoldOut":"Selection Sold Out","slotUnavailable":"{time} on {date} has been selected is unavailable. Please select another slot.","soldOut":"Sold Out","subProductItemsLeft":"({count} items left)","uploadExtensions":"You can only upload following files:","uploadFilesize":"File size cannot be bigger than:","uploadFilesizemin":"File size cannot be smaller than:","url":"This field can only contain a valid URL","validateEmail":"You need to validate this e-mail","wordLimitError":"Too many words. The limit is","wordMinLimitError":"Too few words.  The minimum is"});
      FormTranslation.init({"detectUserLanguage":"1","firstPageOnly":"0","options":"English (US)","originalLanguage":"en","primaryLanguage":"en","saveUserLanguage":"1","showStatus":"flag-with-nation","theme":"light-theme","version":"2"});
	/*INIT-END*/
	});

   JotForm.prepareCalculationsOnTheFly([null,null,null,{"name":"firstName","qid":"3","text":"First Name","type":"control_textbox"},null,null,null,null,{"name":"submit","qid":"8","text":"Submit","type":"control_button"},{"name":"lastName","qid":"9","text":"Last Name","type":"control_textbox"},{"name":"email10","qid":"10","text":"E-mail","type":"control_textbox"},{"name":"phone","qid":"11","text":"Phone","type":"control_textbox"},null,null,null,null,null,null,null,{"name":"otherDetails","qid":"19","text":"Other Details","type":"control_textarea"},{"description":"","name":"company","qid":"20","subLabel":"","text":"Company","type":"control_textbox"},{"description":"","name":"pleaseVerify","qid":"21","text":"Please verify that you are human","type":"control_captcha"},null,{"name":"input23","qid":"23","text":"Bring Keynote Safety Speaker Mike Mullane to your facility to deliver a very powerful, profound and impactful safety message that will alter people’s attitude towards safety forever! GUARANTEED!\nFor pricing and availability please send us an email at info@charliemorecraft.com or fill out the form below.\nContact Details: +1 (561) 997-1120 Toll Free: (800) 783-0796Email: info@charliemorecraft.com Website: https:\u002F\u002Fcharliemorecraft.com\u002Fmotivational-safety-presentations\u002F","type":"control_text"},null,{"description":"","name":"eventDates","qid":"25","subLabel":"","text":"Event Date(s) and\u002For Location(s)","type":"control_textarea"},{"description":"","name":"keynoteSafety","qid":"26","subLabel":"","text":"Keynote Safety Speaker","type":"control_dropdown"}]);
   setTimeout(function() {
JotForm.paymentExtrasOnTheFly([null,null,null,{"name":"firstName","qid":"3","text":"First Name","type":"control_textbox"},null,null,null,null,{"name":"submit","qid":"8","text":"Submit","type":"control_button"},{"name":"lastName","qid":"9","text":"Last Name","type":"control_textbox"},{"name":"email10","qid":"10","text":"E-mail","type":"control_textbox"},{"name":"phone","qid":"11","text":"Phone","type":"control_textbox"},null,null,null,null,null,null,null,{"name":"otherDetails","qid":"19","text":"Other Details","type":"control_textarea"},{"description":"","name":"company","qid":"20","subLabel":"","text":"Company","type":"control_textbox"},{"description":"","name":"pleaseVerify","qid":"21","text":"Please verify that you are human","type":"control_captcha"},null,{"name":"input23","qid":"23","text":"Bring Keynote Safety Speaker Mike Mullane to your facility to deliver a very powerful, profound and impactful safety message that will alter people’s attitude towards safety forever! GUARANTEED!\nFor pricing and availability please send us an email at info@charliemorecraft.com or fill out the form below.\nContact Details: +1 (561) 997-1120 Toll Free: (800) 783-0796Email: info@charliemorecraft.com Website: https:\u002F\u002Fcharliemorecraft.com\u002Fmotivational-safety-presentations\u002F","type":"control_text"},null,{"description":"","name":"eventDates","qid":"25","subLabel":"","text":"Event Date(s) and\u002For Location(s)","type":"control_textarea"},{"description":"","name":"keynoteSafety","qid":"26","subLabel":"","text":"Keynote Safety Speaker","type":"control_dropdown"}]);}, 20); 
</script>
<link href="https://cdn01.jotfor.ms/static/formCss.css?3.3.39252" rel="stylesheet" type="text/css" />
<style type="text/css">@media print{.form-section{display:inline!important}.form-pagebreak{display:none!important}.form-section-closed{height:auto!important}.page-section{position:initial!important}}</style>
<link type="text/css" rel="stylesheet" href="https://cdn02.jotfor.ms/css/styles/nova.css?3.3.39252" />
<link type="text/css" rel="stylesheet" href="https://cdn03.jotfor.ms/themes/CSS/566a91c2977cdfcd478b4567.css?themeRevisionID=58c6459d9a11c7136a8b4567"/>
<link type="text/css" rel="stylesheet" href="https://cdn01.jotfor.ms/css/styles/payment/payment_feature.css?3.3.39252" />
<style type="text/css">


    .form-label-left{
        width:150px;
    }
    .form-line{
        padding-top:5px;
        padding-bottom:5px;
    }
    .form-label-right{
        width:150px;
    }
    .form-all{
        width:480px;
        color:#555 !important;
        font-family:'Roboto';
        font-size:14px;
    }
    .form-radio-item label, .form-checkbox-item label, .form-grading-label, .form-header{
        color: #0D0D0D;
    }

</style>

<style type="text/css" id="form-designer-style">
@import "https://fonts.googleapis.com/css?family=Roboto:light,lightitalic,normal,italic,bold,bolditalic";
@import (css) "@{buttonFontLink}";
    /* Injected CSS Code */

.form-all {
  font-family: "Roboto", sans-serif;
}
.form-all {
  width: 480px;
}
.form-label-left,
.form-label-right {
  width: 150px;
}
.form-label {
  white-space: normal;
}
.form-label.form-label-auto {
  display: block;
  float: none;
  text-align: left;
}
.form-label-left {
  display: inline-block;
  white-space: normal;
  float: left;
  text-align: left;
}
.form-label-right {
  display: inline-block;
  white-space: normal;
  float: left;
  text-align: right;
}
.form-label-top {
  white-space: normal;
  display: block;
  float: none;
  text-align: left;
}
.form-radio-item label:before {
  top: 0;
}
.form-all {
  font-size: 14px;
}
.form-label {
  font-weight: normal;
  font-size: 0.95em;
}
.supernova {
  background-color: #ffffff;
}
.supernova body {
  background-color: transparent;
}
/*
@width30: (unit(@formWidth, px) + 60px);
@width60: (unit(@formWidth, px)+ 120px);
@width90: (unit(@formWidth, px)+ 180px);
*/
/* | */
@media screen and (min-width: 480px) {
  .supernova .form-all {
    border: 1px solid #e6e6e6;
    -webkit-box-shadow: 0 3px 9px rgba(0, 0, 0, 0.1);
    -moz-box-shadow: 0 3px 9px rgba(0, 0, 0, 0.1);
    box-shadow: 0 3px 9px rgba(0, 0, 0, 0.1);
  }
}
/* | */
/* | */
@media screen and (max-width: 480px) {
  .jotform-form {
    padding: 10px 0;
  }
}
/* | */
/* | */
@media screen and (min-width: 480px) and (max-width: 768px) {
  .jotform-form {
    padding: 30px 0;
  }
}
/* | */
/* | */
@media screen and (min-width: 480px) and (max-width: 479px) {
  .jotform-form {
    padding: 30px 0;
  }
}
/* | */
/* | */
@media screen and (min-width: 768px) {
  .jotform-form {
    padding: 60px 0;
  }
}
/* | */
/* | */
@media screen and (max-width: 479px) {
  .jotform-form {
    padding: 12px;
  }
}
/* | */
.supernova .form-all,
.form-all {
  background-color: #ffffff;
  border: 1px solid transparent;
}
.form-header-group {
  border-color: #e6e6e6;
}
.form-matrix-table tr {
  border-color: #e6e6e6;
}
.form-matrix-table tr:nth-child(2n) {
  background-color: #f2f2f2;
}
.form-all {
  color: #555555;
}
.form-header-group .form-header {
  color: #555555;
}
.form-header-group .form-subHeader {
  color: #6f6f6f;
}
.form-sub-label {
  color: #6f6f6f;
}
.form-label-top,
.form-label-left,
.form-label-right,
.form-html {
  color: #6f6f6f;
}
.form-checkbox-item label,
.form-radio-item label {
  color: #555555;
}
.form-line.form-line-active {
  -webkit-transition-property: all;
  -moz-transition-property: all;
  -ms-transition-property: all;
  -o-transition-property: all;
  transition-property: all;
  -webkit-transition-duration: 0.3s;
  -moz-transition-duration: 0.3s;
  -ms-transition-duration: 0.3s;
  -o-transition-duration: 0.3s;
  transition-duration: 0.3s;
  -webkit-transition-timing-function: ease;
  -moz-transition-timing-function: ease;
  -ms-transition-timing-function: ease;
  -o-transition-timing-function: ease;
  transition-timing-function: ease;
  background-color: rgba(255, 255, 224, 0);
}
/* omer */
.form-radio-item,
.form-checkbox-item {
  padding-bottom: 0px !important;
}
.form-radio-item:last-child,
.form-checkbox-item:last-child {
  padding-bottom: 0;
}
/* omer */
.form-single-column .form-checkbox-item,
.form-single-column .form-radio-item {
  width: 100%;
}
.supernova {
  height: 100%;
  background-repeat: no-repeat;
  background-attachment: scroll;
  background-position: center top;
  background-repeat: repeat;
}
.supernova {
  background-image: none;
}
#stage {
  background-image: none;
}
/* | */
.form-all {
  background-repeat: no-repeat;
  background-attachment: scroll;
  background-position: center top;
  background-repeat: repeat;
}
.form-header-group {
  background-repeat: no-repeat;
  background-attachment: scroll;
  background-position: center top;
}
.form-line {
  margin-top: 0px;
  margin-bottom: 0px;
}
.form-line {
  padding: 8px 36px;
}
.form-all .form-textbox,
.form-all .form-radio-other-input,
.form-all .form-checkbox-other-input,
.form-all .form-captcha input,
.form-all .form-spinner input,
.form-all .form-pagebreak-back,
.form-all .form-pagebreak-next,
.form-all .qq-upload-button,
.form-all .form-error-message {
  -webkit-border-radius: 6px;
  -moz-border-radius: 6px;
  border-radius: 6px;
}
.form-all .form-sub-label {
  margin-left: 3px;
}
.form-all .form-textarea {
  -webkit-border-radius: 6px;
  -moz-border-radius: 6px;
  border-radius: 6px;
}
.form-all {
  -webkit-border-radius: 6px;
  -moz-border-radius: 6px;
  border-radius: 6px;
}
.form-section:first-child {
  -webkit-border-radius: 6px 6px 0 0;
  -moz-border-radius: 6px 6px 0 0;
  border-radius: 6px 6px 0 0;
}
.form-section:last-child {
  -webkit-border-radius: 0 0 6px 6px;
  -moz-border-radius: 0 0 6px 6px;
  border-radius: 0 0 6px 6px;
}
.form-all .qq-upload-button,
.form-all .form-submit-button,
.form-all .form-submit-reset,
.form-all .form-submit-print {
  font-size: 1em;
  padding: 9px 15px;
  font-family: "Roboto", sans-serif;
  font-size: 14px;
  font-weight: normal;
}
.form-all .form-pagebreak-back,
.form-all .form-pagebreak-next {
  font-size: 1em;
  padding: 9px 15px;
  font-family: "Roboto", sans-serif;
  font-size: 14px;
  font-weight: normal;
}
/*
& when ( @buttonFontType = google ) {
	
}
*/
h2.form-header {
  line-height: 1.618em;
  font-size: 1.714em;
}
h2 ~ .form-subHeader {
  line-height: 1.5em;
  font-size: 1.071em;
}
.form-header-group {
  text-align: left;
}
/*.form-dropdown,
.form-radio-item,
.form-checkbox-item,
.form-radio-other-input,
.form-checkbox-other-input,*/
.form-captcha input,
.form-spinner input,
.form-error-message {
  padding: 4px 3px 2px 3px;
}
.form-header-group {
  font-family: "Roboto", sans-serif;
}
.form-section {
  padding: 0px 0px 0px 0px;
}
.form-header-group {
  margin: 0px 0px 0px 0px;
}
.form-header-group {
  padding: 12px 36px 12px 36px;
}
.form-header-group {
  background-color: #f5f5f5;
}
.form-textbox,
.form-textarea {
  padding: 4px 3px 2px 3px;
}
.form-textbox,
.form-textarea,
.form-radio-other-input,
.form-checkbox-other-input,
.form-captcha input,
.form-spinner input {
  background-color: #ffffff;
}
[data-type="control_dropdown"] .form-input,
[data-type="control_dropdown"] .form-input-wide {
  width: 150px;
}
.form-label {
  font-family: "Roboto", sans-serif;
}
li[data-type="control_image"] div {
  text-align: left;
}
li[data-type="control_image"] img {
  border: none;
  border-width: 0px !important;
  border-style: solid !important;
  border-color: false !important;
}
.form-line-column {
  width: auto;
}
.form-line-error {
  background-color: #ffffff;
  -webkit-box-shadow: inset 0px 3px 11px -7px #ff3200;
  -moz-box-shadow: inset 0px 3px 11px -7px #ff3200;
  box-shadow: inset 0px 3px 11px -7px #ff3200;
}
.form-line-error input:not(#coupon-input),
.form-line-error textarea,
.form-line-error .form-validation-error {
  -webkit-transition-property: none;
  -moz-transition-property: none;
  -ms-transition-property: none;
  -o-transition-property: none;
  transition-property: none;
  -webkit-transition-duration: 0.3s;
  -moz-transition-duration: 0.3s;
  -ms-transition-duration: 0.3s;
  -o-transition-duration: 0.3s;
  transition-duration: 0.3s;
  -webkit-transition-timing-function: ease;
  -moz-transition-timing-function: ease;
  -ms-transition-timing-function: ease;
  -o-transition-timing-function: ease;
  transition-timing-function: ease;
  border: 1px solid #fff4f4;
  -moz-box-shadow: 0 0 3px #fff4f4;
  -webkit-box-shadow: 0 0 3px #fff4f4;
  box-shadow: 0 0 3px #fff4f4;
}
.form-line-error .form-error-message {
  margin: 0;
  position: absolute;
  color: #fff;
  display: inline-block;
  right: 0;
  font-size: 10px;
  position: absolute!important;
  box-shadow: none;
  top: 0px;
  line-height: 20px;
  color: #FFF;
  background: #ff3200;
  padding: 0px 5px;
  bottom: auto;
  min-width: 105px;
  -webkit-border-radius: 0;
  -moz-border-radius: 0;
  border-radius: 0;
}
.form-line-error .form-error-message img,
.form-line-error .form-error-message .form-error-arrow {
  display: none;
}
.ie-8 .form-all {
  margin-top: auto;
  margin-top: initial;
}
.ie-8 .form-all:before {
  display: none;
}
/* | */
@media screen and (max-width: 480px), screen and (max-device-width: 768px) and (orientation: portrait), screen and (max-device-width: 415px) and (orientation: landscape) {
  .testOne {
    letter-spacing: 0;
  }
  .jotform-form {
    padding: 12px 0 0 0;
  }
  .form-all {
    border: 0;
    width: 94%!important;
    max-width: initial;
  }
  .form-sub-label-container {
    width: 100%;
    margin: 0;
    margin-right: 0;
    float: left;
    -moz-box-sizing: border-box;
    -webkit-box-sizing: border-box;
    box-sizing: border-box;
  }
  span.form-sub-label-container + span.form-sub-label-container {
    margin-right: 0;
  }
  .form-sub-label {
    white-space: normal;
  }
  .form-address-table td,
  .form-address-table th {
    padding: 0 1px 10px;
  }
  .form-submit-button,
  .form-submit-print,
  .form-submit-reset {
    width: 100%;
    margin-left: 0!important;
  }
  div[id*=at_] {
    font-size: 14px;
    font-weight: 700;
    height: 8px;
    margin-top: 6px;
  }
  .showAutoCalendar {
    width: 20px;
  }
  img.form-image {
    max-width: 100%;
    height: auto;
  }
  .form-matrix-row-headers {
    width: 100%;
    word-break: break-all;
    min-width: 40px;
  }
  .form-collapse-table,
  .form-header-group {
    margin: 0;
  }
  .form-collapse-table {
    height: 100%;
    display: inline-block;
    width: 100%;
  }
  .form-collapse-hidden {
    display: none !important;
  }
  .form-input {
    width: 100%;
  }
  .form-label {
    width: 100% !important;
  }
  .form-label-left,
  .form-label-right {
    display: block;
    float: none;
    text-align: left;
    width: auto!important;
  }
  .form-line,
  .form-line.form-line-column {
    padding: 2% 5%;
    -moz-box-sizing: border-box;
    -webkit-box-sizing: border-box;
    box-sizing: border-box;
  }
  input[type=text],
  input[type=email],
  input[type=tel],
  textarea {
    width: 100%;
    -moz-box-sizing: border-box;
    -webkit-box-sizing: border-box;
    box-sizing: border-box;
    max-width: initial !important;
  }
  .form-dropdown,
  .form-textarea,
  .form-textbox {
    width: 100%!important;
    -moz-box-sizing: border-box;
    -webkit-box-sizing: border-box;
    box-sizing: border-box;
  }
  .form-input,
  .form-input-wide,
  .form-textarea,
  .form-textbox,
  .form-dropdown {
    max-width: initial!important;
  }
  .form-address-city,
  .form-address-line,
  .form-address-postal,
  .form-address-state,
  .form-address-table,
  .form-address-table .form-sub-label-container,
  .form-address-table select,
  .form-input {
    width: 100%;
  }
  div.form-header-group {
    padding: 12px 36px !important;
    padding-left: 5%!important;
    padding-right: 5%!important;
    margin: 0 0px 2% !important;
    -moz-box-sizing: border-box;
    -webkit-box-sizing: border-box;
    box-sizing: border-box;
  }
  div.form-header-group.hasImage img {
    max-width: 100%;
  }
  [data-type="control_button"] {
    margin-bottom: 0 !important;
  }
  [data-type=control_fullname] .form-sub-label-container {
    width: 48%;
  }
  [data-type=control_fullname] .form-sub-label-container:first-child {
    margin-right: 4%;
  }
  [data-type=control_phone] .form-sub-label-container {
    width: 65%;
  }
  [data-type=control_phone] .form-sub-label-container:first-child {
    width: 31%;
    margin-right: 4%;
  }
  [data-type=control_datetime] .form-sub-label-container + .form-sub-label-container,
  [data-type=control_datetime] .form-sub-label-container:first-child {
    width: 27.3%;
    margin-right: 6%;
  }
  [data-type=control_datetime] .form-sub-label-container + .form-sub-label-container + .form-sub-label-container {
    width: 33.3%;
    margin-right: 0;
  }
  [data-type=control_datetime] span + span + span > span:first-child {
    display: block;
    width: 100% !important;
  }
  [data-type=control_birthdate] .form-sub-label-container,
  [data-type=control_datetime] span + span + span > span:first-child + span + span,
  [data-type=control_time] .form-sub-label-container {
    width: 27.3%!important;
    margin-right: 6% !important;
  }
  [data-type=control_birthdate] .form-sub-label-container:last-child,
  [data-type=control_time] .form-sub-label-container:last-child {
    width: 33.3%!important;
    margin-right: 0 !important;
  }
  .form-pagebreak-back-container,
  .form-pagebreak-next-container {
    width: 50% !important;
  }
  .form-pagebreak-back,
  .form-pagebreak-next,
  .form-product-item.hover-product-item {
    width: 100%;
  }
  .form-pagebreak-back-container {
    padding: 0;
    text-align: right;
  }
  .form-pagebreak-next-container {
    padding: 0;
    text-align: left;
  }
  .form-pagebreak {
    margin: 0 auto;
  }
  .form-buttons-wrapper {
    margin: 0!important;
    margin-left: 0!important;
  }
  .form-buttons-wrapper button {
    width: 100%;
  }
  .form-buttons-wrapper .form-submit-print {
    margin: 0 !important;
  }
  table {
    width: 100%!important;
    max-width: initial!important;
  }
  table td + td {
    padding-left: 3%;
  }
  .form-checkbox-item,
  .form-radio-item {
    white-space: normal!important;
  }
  .form-checkbox-item input,
  .form-radio-item input {
    width: auto;
  }
  .form-collapse-table {
    margin: 0 5%;
    display: block;
    zoom: 1;
    width: auto;
  }
  .form-collapse-table:before,
  .form-collapse-table:after {
    display: table;
    content: '';
    line-height: 0;
  }
  .form-collapse-table:after {
    clear: both;
  }
  .fb-like-box {
    width: 98% !important;
  }
  .form-error-message {
    clear: both;
    bottom: -10px;
  }
  .date-separate,
  .phone-separate {
    display: none;
  }
  .custom-field-frame,
  .direct-embed-widgets,
  .signature-pad-wrapper {
    width: 100% !important;
  }
}
/* | */

/*PREFERENCES STYLE*/
    .form-all {
      font-family: Roboto, sans-serif;
    }
    .form-all .qq-upload-button,
    .form-all .form-submit-button,
    .form-all .form-submit-reset,
    .form-all .form-submit-print {
      font-family: Roboto, sans-serif;
    }
    .form-all .form-pagebreak-back-container,
    .form-all .form-pagebreak-next-container {
      font-family: Roboto, sans-serif;
    }
    .form-header-group {
      font-family: Roboto, sans-serif;
    }
    .form-label {
      font-family: Roboto, sans-serif;
    }
  
    .form-label.form-label-auto {
      
    display: block;
    float: none;
    text-align: left;
    width: 100%;
  
    }
  
    .form-line {
      margin-top: 5px;
      margin-bottom: 5px;
    }
  
    .form-all {
      max-width: 480px;
      width: 100%;
    }
  
    .form-label.form-label-left,
    .form-label.form-label-right,
    .form-label.form-label-left.form-label-auto,
    .form-label.form-label-right.form-label-auto {
      width: 150px;
    }
  
    .form-all {
      font-size: 14px
    }
    .form-all .qq-upload-button,
    .form-all .qq-upload-button,
    .form-all .form-submit-button,
    .form-all .form-submit-reset,
    .form-all .form-submit-print {
      font-size: 14px
    }
    .form-all .form-pagebreak-back-container,
    .form-all .form-pagebreak-next-container {
      font-size: 14px
    }
  
    .supernova .form-all, .form-all {
      background-color: #fff;
    }
  
    .form-all {
      color: #555;
    }
    .form-header-group .form-header {
      color: #555;
    }
    .form-header-group .form-subHeader {
      color: #555;
    }
    .form-label-top,
    .form-label-left,
    .form-label-right,
    .form-html,
    .form-checkbox-item label,
    .form-radio-item label,
    span.FITB .qb-checkbox-label,
    span.FITB .qb-radiobox-label,
    span.FITB .form-radio label,
    span.FITB .form-checkbox label,
    [data-blotid][data-type=checkbox] [data-labelid],
    [data-blotid][data-type=radiobox] [data-labelid],
    span.FITB-inptCont[data-type=checkbox] label,
    span.FITB-inptCont[data-type=radiobox] label {
      color: #555;
    }
    .form-sub-label {
      color: #6f6f6f;
    }
  
    .supernova {
      background-color: rgb(255, 255, 255);
    }
    .supernova body {
      background: transparent;
    }
  
    .form-textbox,
    .form-textarea,
    .form-dropdown,
    .form-radio-other-input,
    .form-checkbox-other-input,
    .form-captcha input,
    .form-spinner input {
      background-color: #fff;
    }
  
    .supernova {
      background-image: none;
    }
    #stage {
      background-image: none;
    }
  
    .form-all {
      background-image: none;
    }
  
    .form-all {
      position: relative;
    }
    .form-all:before {
      content: "";
      background-image: url("https://www.jotform.com/uploads/WEBSITEFLIX/form_files/mike-mullate-keynote-safety-speaker-.63eabe4aa0e807.90997477.jpg");
      display: inline-block;
      height: 212.65822784810126px;
      position: absolute;
      background-size: 480px 212px;
      background-repeat: no-repeat;
      width: 100%;
    }
    .form-all {
      margin-top: 222px !important;
    }
    .form-all:before {
      top: -222px;
      left: 0;
      background-position: top left;
    }
           
  .ie-8 .form-all:before { display: none; }
  .ie-8 {
    margin-top: auto;
    margin-top: initial;
  }
  
  /*PREFERENCES STYLE*//*__INSPECT_SEPERATOR__*/
/*---------------------
Theme: Generic Theme
Author: Elton Cris - idarktech@jotform.com
www.jotform.com
----------------------*/
.form-all {
    -moz-box-sizing : border-box;
    -webkit-box-sizing : border-box;
    box-sizing : border-box;
    -moz-box-shadow : 0 1px 4px rgba(0, 0, 0, .25);
    -webkit-box-shadow : 0 1px 4px rgba(0, 0, 0, .25);
    box-shadow : 0 1px 4px rgba(0, 0, 0, .25) !important;
}

[data-type="control_head"] {
    padding-bottom : 20px;
}

/*responsive fields*/
[data-type="control_textbox"] .form-textbox, 
[data-type="control_fullname"] .form-textbox,
[data-type="control_email"] .form-textbox,
[data-type="control_textarea"] .form-textarea, 
[data-type="control_dropdown"] .form-dropdown {
    width : 100% !important;
    max-width : none !important;
}

.form-textbox, .form-textarea, .form-dropdown {
    max-width : none !important;
    box-shadow : none;
    outline : none;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
    -moz-box-sizing : border-box;
    font-family : inherit;
    padding : 8px;
    transition : .3s ease-in-out;
    box-shadow : 0 1px 2px rgba(0, 0, 0, .15) inset;
}

.form-textarea-limit>span {
    display : block;
}

[data-type="control_dropdown"] .form-input, 
[data-type="control_dropdown"] .form-input-wide {
    width : 100%;
}

/*input focus*/
.form-line-active input:focus, .form-line-active textarea:focus, .form-line-active select:focus {
    outline : 0;
    border-color : 1px solid rgba(82, 168, 236, 0.8) !important;
    box-shadow : inset 0 1px 3px rgba(0, 0, 0, 0.1),0 0 8px rgba(82, 168, 236, 0.6);
}

/*reset error*/
.form-line-error {
    box-shadow : none;
}

/*input error*/
.form-line-error input:not(#coupon-input), .form-line-error textarea, .form-line-error select, .form-line-error .form-validation-error {
    border : 1px solid #e15353 !important;
    box-shadow : none !important;
}

.form-line-active {
    color : inherit !important;
}

/*responsive content -wide or shrink*/
.form-label {
    width : 35% !important;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
    -moz-box-sizing : border-box;
}

.form-label-top {
    width : 100% !important;
}

.form-line {
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
    -moz-box-sizing : border-box;
    width : 100%;
}

.form-checkbox-other-input {
    width : 80% !important;
}

.form-input {
    width : 65% !important;
    max-width : none !important;
}

.form-input-wide {
    max-width : none !important;
    display : inline-block;
    width : 100%;
}

/*single fields with sublabels*/
[data-type="control_textbox"] .form-input-wide .form-sub-label-container, 
[data-type="control_fullname"] .form-input-wide .form-sub-label-container,
[data-type="control_email"] .form-input-wide .form-sub-label-container,
[data-type="control_textarea"] .form-input-wide .form-sub-label-container, 
[data-type="control_dropdown"] .form-input-wide .form-sub-label-container,
[data-type="control_textbox"] .form-input .form-sub-label-container, 
[data-type="control_fullname"] .form-input .form-sub-label-container,
[data-type="control_email"] .form-input .form-sub-label-container,
[data-type="control_textarea"] .form-input .form-sub-label-container, 
[data-type="control_dropdown"] .form-input .form-sub-label-container {
    width : 100%;
    max-width : none !important;
}

[data-type="control_dropdown"] .form-input-wide {
    width : 100%;
}

/*responsive full name*/
[data-type="control_fullname"] .form-sub-label-container {
    width : 50% !important;
    margin : 0 !important;
    float : left;
    box-sizing : border-box;
}

[data-type="control_fullname"] .form-label + div .form-sub-label-container {
    display : inline-block;
    padding-right : 5px;
}

[data-type="control_fullname"] .form-label + div .form-sub-label-container + .form-sub-label-container {
    margin-right : 0;
    padding-right : 0;
    padding-left : 5px;
}

[data-type="control_fullname"] .form-label + div .form-sub-label-container + .form-sub-label-container {
    margin-right : 0;
    padding-right : 0;
    padding-left : 5px;
}

[data-type="control_fullname"] .form-label + div .form-sub-label-container + .form-sub-label-container + .form-sub-label-container {
    padding-left : 0;
    padding-right : 5px;
}

[data-type="control_fullname"] .form-label + div .form-sub-label-container + .form-sub-label-container + .form-sub-label-container + .form-sub-label-container {
    padding-left : 5px;
    padding-right : 0;
}

[data-type="control_fullname"] .form-label + div .form-sub-label-container + .form-sub-label-container  + .form-sub-label-container + .form-sub-label-container + .form-sub-label-container {
    padding-right : 5px;
    padding-left : 0;
}

#sublabel_prefix, #sublabel_first, #sublabel_middle {
    /*margin-bottom : 10px;
    */;
}

/*remove sepatators on date and phone*/
.phone-separate, .date-separate {
    display : none;
}

/*responsive phone fields*/
[data-type="control_phone"] input[name$="[area]"] {
    width : 100%;
}

[data-type="control_phone"] input[name$="[phone]"] {
    width : 100%;
}

[data-type="control_phone"] input[name$="[full]"] {
    width : 100%;
}

[data-type="control_phone"] .form-sub-label-container {
    width : 40%;
    float : left;
    box-sizing : border-box;
    margin-right : 0;
    padding-right : 12px;
}

/* responsive date time field */
[data-type="control_datetime"] .form-textbox,
[data-type="control_datetime"] .form-dropdown {
    width : 100%;
}

[data-type="control_datetime"] .form-sub-label-container {
    width : 28%;
    padding-left : 4px;
    box-sizing : border-box;
    margin-right : 0;
}

[data-type="control_datetime"] .form-sub-label-container:first-child {
    padding-left : 0;
}

[data-type="control_datetime"] .form-sub-label-container:first-child + .form-sub-label-container + .form-sub-label-container {
    padding-right : 0;
}

[data-type="control_datetime"] .form-sub-label-container:last-child {
    width : auto !important;
}

.allowTime-container .form-sub-label-container:last-child {
    width : 20% !important;
}

span.allowTime-container {
    width : 80%;
    padding-top : 14px;
}

.allowTime-container span.form-sub-label-container {
    width : 35%;
}

span.allowTime-container .form-dropdown {
    width : 100%;
}

span.allowTime-container > span:first-child {
    display : none;
}

span.allowTime-container > span:first-child + span {
    padding-left : 0;
}

.showAutoCalendar + label {
    display : none;
}

span.allowTime-container + span {
    padding-top : 14px;
}

/*calendar lite mode*/
[data-type="control_datetime"] div[style*="none"] + .form-sub-label-container {
    width : 84%;
    padding-left : 0;
}

/*responsive phone field*/
[data-type="control_phone"] .form-sub-label-container + .form-sub-label-container {
    width : 60%;
    margin-right : 0;
    padding-right : 0;
    padding-left : 12px;
}

/*responsive full address fields*/
.form-address-city, .form-address-line, .form-address-postal, 
.form-address-state, .form-address-table, 
.form-address-table .form-sub-label-container, .form-address-table select {
    width : 100%;
    max-width : 100%;
}

[data-type="control_address"] input[name$="[city]"],
[data-type="control_address"] input[name$="[postal]"] {
    width : 90% !important;
}

[data-type="control_address"] input[name$="[area]"] {
    width : 60%;
}

/*reset submit button*/
[data-type="control_button"] {
    background : transparent !important;
}

.form-submit-button,
.form-submit-reset,
.form-submit-print {
    outline : none;
}

/*remove other checkbox*/
.form-checkbox-other, 
.form-radio-other {
    visibility : hidden !important;
}

/*shruken fields*/
.form-line-column {
    width : 50%;
}

.form-line-column .form-label-top {
    width : 100% !important;
}

/*fix form builder display*/
div#stage.form-all {
    max-width : none !important;
    margin-right : 0;
}

div#stage .form-input {
    width : 64% !important;
}

/*remove first pagebreak back button*/
.form-all .page-section:first-child .form-pagebreak .form-pagebreak-back-container {
    display : none !important;
}

/* responsive pagebreak */
.form-pagebreak-back-container {
    width : 50% !important;
    text-align : left;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
    float : left;
}

.form-pagebreak-next-container {
    width : 50% !important;
    text-align : right;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
    float : left;
}

/* radio-checkbox button make border 1px */
.form-radio-item:not(#foo) label:after,
.form-radio-item:not(#foo) label:before {
    border-radius : 50%;
}

.form-checkbox-item:not(#foo) label:after,
.form-checkbox-item:not(#foo) label:before {
    border-radius : 0;
}

.form-radio-item:not(#foo) label:before,
.form-checkbox-item:not(#foo) label:before {
    border-width : 1px;
}

/*responsive credit card on payment fields*/
table td + td {
    padding-left : 0;
}

.form-address-table {
    width : 100%;
}

[data-type="control_stripe"] .form-address-table,
[data-type="control_stripe"] .form-address-table .form-textbox,
[data-type="control_authnet"] .form-address-table,
[data-type="control_authnet"] .form-address-table .form-textbox,
#creditCardTable.form-address-table,
#creditCardTable.form-address-table .form-textbox {
    max-width : none;
}

[data-type="control_stripe"] .form-address-table td:last-child .form-sub-label-container,
[data-type="control_authnet"] .form-address-table td:last-child .form-sub-label-container,
#creditCardTable.form-address-table td:last-child .form-sub-label-container {
    margin-left : 0;
    white-space : normal;
}

[data-type="control_stripe"] .form-address-table td .form-sub-label-container,
[data-type="control_authnet"] .form-address-table td .form-sub-label-container,
#creditCardTable.form-address-table td .form-sub-label-container {
    width : 100%;
}

[data-type="control_stripe"] .form-address-table .form-textbox,
[data-type="control_stripe"] .form-address-table .form-dropdown,
[data-type="control_authnet"] .form-address-table .form-textbox,
[data-type="control_authnet"] .form-address-table .form-dropdown,
#creditCardTable.form-address-table .form-textbox,
#creditCardTable.form-address-table .form-dropdown {
    width : 100%;
    visibility : visible;
}

[data-type="control_stripe"] .form-address-table tbody > tr:first-child + tr td:first-child span,
[data-type="control_authnet"] .form-address-table tbody > tr:first-child + tr td:first-child span,
#creditCardTable.form-address-table tbody > tr:first-child + tr td:first-child span {
    margin : 0;
    padding-right : 6px;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
}

[data-type="control_stripe"] .form-address-table tbody > tr:first-child + tr td:first-child + td span,
[data-type="control_authnet"] .form-address-table tbody > tr:first-child + tr td:first-child + td span,
#creditCardTable.form-address-table tbody > tr:first-child + tr td:first-child + td span {
    margin : 0;
    padding-left : 6px;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
}

[data-type="control_stripe"] .form-address-table tbody > tr:first-child + tr +tr td:first-child span,
[data-type="control_stripe"] .form-address-table tbody > tr:first-child + tr +tr+tr td:first-child span,
[data-type="control_authnet"] .form-address-table tbody > tr:first-child + tr +tr td:first-child span,
[data-type="control_authnet"] .form-address-table tbody > tr:first-child + tr +tr+tr td:first-child span,
#creditCardTable.form-address-table tbody > tr:first-child + tr +tr td:first-child span,
#creditCardTable.form-address-table tbody > tr:first-child + tr +tr+tr td:first-child span {
    margin : 0;
    padding-right : 6px;
    width : 50% !important;
    visibility : hidden;
    float : left;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
}

[data-type="control_stripe"] .form-address-table tbody > tr:first-child + tr +tr td:first-child span + span,
[data-type="control_stripe"] .form-address-table tbody > tr:first-child + tr +tr+tr td:first-child span + span,
[data-type="control_authnet"] .form-address-table tbody > tr:first-child + tr +tr td:first-child span + span,
[data-type="control_authnet"] .form-address-table tbody > tr:first-child + tr +tr+tr td:first-child span + span,
#creditCardTable.form-address-table tbody > tr:first-child + tr +tr td:first-child span + span,
#creditCardTable.form-address-table tbody > tr:first-child + tr +tr+tr td:first-child span + span {
    margin : 0;
    padding-top : 0 !important;
    padding-right : 0;
    padding-left : 6px;
    width : 50% !important;
    box-sizing : border-box;
    -webkit-box-sizing : border-box;
}

.cc_ccv {
    width : 100% !important;
}

[data-type="control_stripe"] .form-address-table .form-sub-label,
[data-type="control_authnet"] .form-address-table .form-sub-label,
#creditCardTable.form-address-table .form-sub-label {
    visibility : visible;
}

/*cc fix city state, country */
[data-type="control_stripe"] .form-address-table td[width="50%"]>span:first-child,
[data-type="control_authnet"] .form-address-table td[width="50%"]>span:first-child,
#creditCardTable.form-address-table td[width="50%"]>span:first-child {
    box-sizing : border-box;
    padding-right : 7px;
}

[data-type="control_stripe"] .form-address-table td[width="50%"] + td >span:first-child,
[data-type="control_authnet"] .form-address-table td[width="50%"] + td >span:first-child,
#creditCardTable.form-address-table td[width="50%"] + td >span:first-child {
    box-sizing : border-box;
    padding-left : 7px;
}

[data-type="control_stripe"] .form-address-table td[width="50%"] + td[width="50%"] >span:first-child,
[data-type="control_authnet"] .form-address-table td[width="50%"] + td[width="50%"] >span:first-child,
#creditCardTable.form-address-table td[width="50%"] + td[width="50%"] >span:first-child {
    box-sizing : border-box;
    padding-right : 0;
}

.hover-product-item:hover {
    color : inherit;
}

/*fix for braintree cc styling*/
[data-type="control_braintree"] .form-sub-label-container {
    width : 100% !important;
    padding : 4px;
    box-sizing : border-box;
}

[data-type="control_braintree"] .form-textbox {
    width : 100%;
}

.braintree-hosted-fields {
    width : 100% !important;
    box-sizing : border-box;
    min-height : 28px;
}

/*remove bottom spacing on CC section*/
#creditCardTable.form-address-table tbody tr + tr + tr td,
[data-type="control_stripe"] .form-address-table tbody tr + tr + tr td,
[data-type="control_authnet"] .form-address-table tbody tr + tr + tr td {
    padding-bottom : 0;
}

@media screen and (max-device-width:768px){
    .form-all {
        margin : 0 auto !important;
        width : 100% !important;
    }

    [data-type=control_fullname] .form-sub-label-container:first-child {
        margin-right : 0;
    }

}

@media screen and (max-width:480px){
    .jotform-form {
        padding : 0;
    }

    .form-input {
        width : 100% !important;
    }

    .form-label {
        width : 100% !important;
        float : none !important;
    }

    .form-line-column {
        width : 100% !important;
    }

    div.form-header-group {
        margin : 0 !important;
        padding : 24px 20px !important;
    }

    [data-type="control_datetime"] .form-sub-label-container {
        float : left;
    }

    [data-type=control_fullname] .form-sub-label-container:first-child {
        margin-right : 0;
    }

}

/*----fix the new awful error message----*/
li.form-line-error .form-error-message img {
    position: static !important;
    margin-top: 0;
    left: 0;
    top: 0;
    vertical-align: middle;
    padding: 2px 0;
}
li.form-line-error .form-error-message {
    padding: 2px 6px;
}
    /* Injected CSS Code */
</style>

<link type="text/css" rel="stylesheet" href="https://cdn02.jotfor.ms/css/styles/buttons/form-submit-button-black_blue.css?3.3.39252"/>
<form class="jotform-form" action="https://submit.jotform.com/submit/230436426879162/" method="post" name="form_230436426879162" id="230436426879162" accept-charset="utf-8" autocomplete="off"><input type="hidden" name="formID" value="230436426879162" /><input type="hidden" id="JWTContainer" value="" /><input type="hidden" id="cardinalOrderNumber" value="" />
  <div role="main" class="form-all">
    <link type="text/css" rel="stylesheet" media="all" href="https://cdn.jotfor.ms/wizards/languageWizard/custom-dropdown/css/lang-dd.css?3.3.39252" />
    <div class="cont"><input type="text" id="input_language" name="input_language" style="display:none" />
      <div class="language-dd" id="langDd" style="display:none">
        <div class="dd-placeholder lang-emp">Language</div>
        <ul class="lang-list dn" id="langList">
          <li data-lang="en" class="en">English (US)</li>
        </ul>
      </div>
    </div>
    <script type="text/javascript" src="https://cdn.jotfor.ms/js/formTranslation.v2.js?3.3.39252"></script>
    <ul class="form-section page-section">
      <li class="form-line" data-type="control_text" id="id_23">
        <div id="cid_23" class="form-input-wide">
          <div id="text_23" class="form-html" data-component="text" tabindex="0">
            <p>Bring <strong>Keynote Safety Speaker Mike Mullane</strong> to your facility to deliver a very powerful, profound and impactful safety message that will alter people’s attitude towards safety forever! GUARANTEED!</p>
            <p>For pricing and availability please send us an email at <a href="mailto:info@charliemorecraft.com" target="_blank" rel="nofollow">info@charliemorecraft.com</a> or fill out the form below.</p>
            <p>Contact Details: +1 (561) 997-1120 <br />Toll Free: (800) 783-0796<br />Email: <a href="mailto:info@charliemorecraft.com" target="_blank" rel="nofollow">info@charliemorecraft.com</a> <br />Website: <a href="https://charliemorecraft.com/motivational-safety-presentations/" target="_blank" rel="nofollow">https://charliemorecraft.com/motivational-safety-presentations/</a></p>
          </div>
        </div>
      </li>
      <li class="form-line jf-required" data-type="control_textbox" id="id_20"><label class="form-label form-label-top form-label-auto" id="label_20" for="input_20"> Company<span class="form-required">*</span> </label>
        <div id="cid_20" class="form-input-wide jf-required"> <input type="text" id="input_20" name="q20_company" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="20" value="" data-component="textbox" aria-labelledby="label_20" required="" /> </div>
      </li>
      <li class="form-line jf-required" data-type="control_dropdown" id="id_26"><label class="form-label form-label-top form-label-auto" id="label_26" for="input_26"> Keynote Safety Speaker<span class="form-required">*</span> </label>
        <div id="cid_26" class="form-input-wide jf-required"> <select class="form-dropdown validate[required]" id="input_26" name="q26_keynoteSafety" style="width:150px" data-component="dropdown" required="" aria-label="Keynote Safety Speaker">
            <option value="">Please Select</option>
            <option selected="" value="Mike Mullane">Mike Mullane</option>
            <option value="Charlie Morecraft">Charlie Morecraft</option>
          </select> </div>
      </li>
      <li class="form-line form-line-column form-col-1 jf-required" data-type="control_textbox" id="id_3"><label class="form-label form-label-top" id="label_3" for="input_3"> First Name<span class="form-required">*</span> </label>
        <div id="cid_3" class="form-input-wide jf-required"> <input type="text" id="input_3" name="q3_firstName" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="23" value="" placeholder=" " data-component="textbox" aria-labelledby="label_3" required="" /> </div>
      </li>
      <li class="form-line form-line-column form-col-2 jf-required" data-type="control_textbox" id="id_9"><label class="form-label form-label-top" id="label_9" for="input_9"> Last Name<span class="form-required">*</span> </label>
        <div id="cid_9" class="form-input-wide jf-required"> <input type="text" id="input_9" name="q9_lastName" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="25" value="" placeholder=" " data-component="textbox" aria-labelledby="label_9" required="" /> </div>
      </li>
      <li class="form-line form-line-column form-col-1 form-line-column-clear jf-required" data-type="control_textbox" id="id_10"><label class="form-label form-label-top" id="label_10" for="input_10"> E-mail<span class="form-required">*</span> </label>
        <div id="cid_10" class="form-input-wide jf-required"> <input type="text" id="input_10" name="q10_email10" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="23" value="" placeholder=" " data-component="textbox" aria-labelledby="label_10" required="" /> </div>
      </li>
      <li class="form-line form-line-column form-col-2 jf-required" data-type="control_textbox" id="id_11"><label class="form-label form-label-top" id="label_11" for="input_11"> Phone<span class="form-required">*</span> </label>
        <div id="cid_11" class="form-input-wide jf-required"> <input type="text" id="input_11" name="q11_phone" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="25" value="" placeholder=" " data-component="textbox" aria-labelledby="label_11" required="" /> </div>
      </li>
      <li class="form-line jf-required" data-type="control_textarea" id="id_25"><label class="form-label form-label-top form-label-auto" id="label_25" for="input_25"> Event Date(s) and/or Location(s)<span class="form-required">*</span> </label>
        <div id="cid_25" class="form-input-wide jf-required"> <textarea id="input_25" class="form-textarea validate[required]" name="q25_eventDates" cols="40" rows="6" data-component="textarea" required="" aria-labelledby="label_25"></textarea> </div>
      </li>
      <li class="form-line" data-type="control_textarea" id="id_19"><label class="form-label form-label-top form-label-auto" id="label_19" for="input_19"> Other Details </label>
        <div id="cid_19" class="form-input-wide"> <textarea id="input_19" class="form-textarea" name="q19_otherDetails" cols="70" rows="6" data-component="textarea" aria-labelledby="label_19"></textarea> </div>
      </li>
      <li class="form-line jf-required" data-type="control_captcha" id="id_21"><label class="form-label form-label-top form-label-auto" id="label_21" for="input_21"> Please verify that you are human<span class="form-required">*</span> </label>
        <div id="cid_21" class="form-input-wide jf-required">
          <section data-wrapper-react="true">
            <div id="recaptcha_input_21" data-component="recaptcha" data-callback="recaptchaCallbackinput_21" data-expired-callback="recaptchaExpiredCallbackinput_21"></div><input type="hidden" id="input_21" class="hidden validate[required]" name="recaptcha_visible" required="" />
            <script type="text/javascript" src="https://www.google.com/recaptcha/api.js?render=explicit&amp;onload=recaptchaLoadedinput_21"></script>
            <script type="text/javascript">
              var recaptchaLoadedinput_21 = function()
              {
                window.grecaptcha.render($("recaptcha_input_21"),
                {
                  sitekey: '6LdU3CgUAAAAAB0nnFM3M3T0sy707slYYU51RroJ',
                });
                var grecaptchaBadge = document.querySelector('.grecaptcha-badge');
                if (grecaptchaBadge)
                {
                  grecaptchaBadge.style.boxShadow = 'gray 0px 0px 2px';
                }
              };

              /**
               * Called when the reCaptcha verifies the user is human
               * For invisible reCaptcha;
               *   Submit event is stopped after validations and recaptcha is executed.
               *   If a challenge is not displayed, this will be called right after grecaptcha.execute()
               *   If a challenge is displayed, this will be called when the challenge is solved successfully
               *   Submit is triggered to actually submit the form since it is stopped before.
               */
              var recaptchaCallbackinput_21 = function()
              {
                var isInvisibleReCaptcha = false;
                var hiddenInput = $("input_21");
                hiddenInput.setValue(1);
                if (!isInvisibleReCaptcha)
                {
                  if (hiddenInput.validateInput)
                  {
                    hiddenInput.validateInput();
                  }
                }
                else
                {
                  triggerSubmit(hiddenInput.form)
                }

                function triggerSubmit(formElement)
                {
                  var button = formElement.ownerDocument.createElement('input');
                  button.style.display = 'none';
                  button.type = 'submit';
                  formElement.appendChild(button).click();
                  formElement.removeChild(button);
                }
              }

              // not really required for invisible recaptcha
              var recaptchaExpiredCallbackinput_21 = function()
              {
                var hiddenInput = $("input_21");
                hiddenInput.writeAttribute("value", false);
                if (hiddenInput.validateInput)
                {
                  hiddenInput.validateInput();
                }
              }
            </script>
          </section>
        </div>
      </li>
      <li class="form-line" data-type="control_button" id="id_8">
        <div id="cid_8" class="form-input-wide">
          <div data-align="center" class="form-buttons-wrapper form-buttons-center   jsTest-button-wrapperField"><button id="input_8" type="submit" class="form-submit-button form-submit-button-black_blue submit-button jf-form-buttons jsTest-submitField" data-component="button" data-content="">Submit</button></div>
        </div>
      </li>
      <li style="display:none">Should be Empty: <input type="text" name="website" value="" /></li>
    </ul>
  </div>
  <script>
    JotForm.showJotFormPowered = "0";
  </script>
  <script>
    JotForm.poweredByText = "Powered by Jotform";
  </script><input type="hidden" class="simple_spc" id="simple_spc" name="simple_spc" value="230436426879162" />
  <script type="text/javascript">
    var all_spc = document.querySelectorAll("form[id='230436426879162'] .si" + "mple" + "_spc");
    for (var i = 0; i < all_spc.length; i++)
    {
      all_spc[i].value = "230436426879162-230436426879162";
    }
  </script>
</form><script type="text/javascript">JotForm.ownerView=true;</script>
<p>The post <a href="https://www.charlieonsafety.com/charlies-speakers-team-astronaut-mike-mullane/">Charlie&#8217;s Speakers Team &#8211; Astronaut Mike Mullane</a> appeared first on <a href="https://www.charlieonsafety.com">Charlie Morecraft</a>.</p>
]]></content:encoded>
					
					<wfw:commentRss>https://www.charlieonsafety.com/charlies-speakers-team-astronaut-mike-mullane/feed/</wfw:commentRss>
			<slash:comments>0</slash:comments>
		
		
			</item>
	</channel>
</rss>
