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Family Connections: Understanding Borderline Personality Disorder (Finding Compassion and Support When Intense Emotions Impact the Ones You Love)

May 17, 2016 @ 6:30 pm - 8:00 pm

Free

ABOUT THE PROGRAM

Do you feel like you have to walk on eggshells with someone you love? Ever felt overwhelmed by someone’s intense anger or sadness? Are you worried about someone who self harms to manage their emotions? You’re not alone.

Despite advances in mental health services, Borderline Personality Disorder remains one of the most misunderstood and misdiagnosed disorders. As a result, countless individuals and their families are left to suffer in isolation lacking information and feeling unsupported.

However, there is hope. Join us as Karyn Hall and volunteers from NEA.BPD (National Education Alliance for Borderline Personality Disorder) share information about Family Connections, a program that offers a lifeline to families facing the challenges of BPD.

In this engaging and interactive presentation you will learn:

– What BPD is and what it isn’t.

– Strategies for keeping tough conversations constructive.

– Tools for not making intense situations worse.

– Why putting the oxygen mask on yourself first is essential.

– Skills for staying connected to someone you love, even when it doesn’t seem
possible.

Click here for event flyer.


REGISTRATION IS REQUIRED TO ATTEND. Check in will begin 15 minutes before the program starts. Due to video filming, late attendees will be asked to view the program from the Green Room.


ABOUT THE SPEAKERS

K HALL_SMKaryn Hall, PhD, Founder and Director, Dialectical Behavior Therapy Center

Dr. Hall has been in private practice for over twenty years and is the founder and Director of The DBT Center in Houston, Texas. The Center offers both standard and intensive DBT treatment. She focuses on working with treatment resistant depression,chronic anxiety, trauma, suicidality, self-injury, eating disorders and borderline personality disorder. An expert in Dialectical Behavior Therapy, Dr. Hall is a licensed psychologist and a certified coach. She has served as a speaker/trainer for both private and public schools on a national level and has served as a consultant for implementation of DBT in residential treatment and mental health centers. She is a DBT trainer with Treatment Implementation Collaborative and has presented workshops on a local and national level.  She blogs for Psychology Today and PsychCentral. She is co-author of The Power of Validation and author of SAVVY, Mindfulness Exercises, and The Emotionally Sensitive Person. She’s on the board of directors for NEA BPD and the founder of Healing Hearts of Families annual conference.

 

Elizabeth Rose headshotElizabeth Rose, NEA.BPD Family Connections/Tele-Connections program leader, and NEA.BPD Board Member

Elizabeth Rose is a passionate mental health advocate, trained NEA.BPD Family Connections/Tele-Connections leader, NEA.BPD Board Member, an NEA.BPD Recovery and Resource Committee member, and Steering Committee member for Houston’s BPD Support and Recovery group and the 2016 Chairperson of Healing Hearts of Families conference. She is a Domestic Violence/Sexual Assault Hotline Advocate at the Houston Area Women’s Center, and a proud Mother of two adult children, one of who lives with the challenges of BPD.

 

 

Version 2Christina McGhee, NEA.BPD’s Family Connections program leader, speaker and coach for separating and divorcing parents

Christina McGhee believes in the power of connection. When people come together in the face of crisis or challenge, amazing things happen. That belief is the very reason she became involved in NEA.BPD’s Family Connections program and later became a trained volunteer group leader. She also served as a member of the 2016 Healing Hearts of Families conference planning committee.

Professionally, Christina is a speaker and coach who works with separating and divorcing parents on how to put their children first when parents part. Married for over 20 years, she is a stepmom and a mom of four who resides on a ranchette with three dogs, seven rescue cats and an obscene number of chickens.


SPREAD THE WORD – MAY IS BPD AWARENESS MONTH!

In 2008 the US Congress officially designated May as BPD Awareness Month in hopes of educating our Nation about this disorder, the needs of those suffering from it, and significant impact it has on families. Please help us share the message “AWARENESS BRINGS HOPE”  in any way you can so no one person has to suffer one more day.

To learn more visit us at www.borderlinepersonalitydisorder.com

Register

Details

Date:
May 17, 2016
Time:
6:30 pm - 8:00 pm
Cost:
Free
Event Category:
Event Tags:
, , , , , , , ,

Venue

Auditorium
717 Sage Road
Houston, TX 77056 United States
+ Google Map
Phone:
713.871.1004
Website:
hopeandhealingcenter.org
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Arab Emirates' >United Arab Emirates</option><option value='United Kingdom' >United Kingdom</option><option value='United States' selected='selected'>United States</option><option value='Uruguay' >Uruguay</option><option value='Uzbekistan' >Uzbekistan</option><option value='Vanuatu' >Vanuatu</option><option value='Venezuela' >Venezuela</option><option value='Vietnam' >Vietnam</option><option value='Virgin Islands, British' >Virgin Islands, British</option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.</option><option value='Wallis and Futuna' >Wallis and Futuna</option><option value='Western Sahara' >Western Sahara</option><option value='Yemen' >Yemen</option><option value='Zambia' >Zambia</option><option value='Zimbabwe' >Zimbabwe</option><option value='Åland Islands' >Åland Islands</option></select> <label for='input_1_16_6' id='input_1_16_6_label' >Country</label> </span> <div class='gf_clear gf_clear_complex'></div> </div></li><li id="field_1_17" class="gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_17"><label class='gfield_label gfield_label_before_complex' >Work Address<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label> <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address' id='input_1_17' > <span class='ginput_full address_line_1 ginput_address_line_1' id='input_1_17_1_container' > <input type='text' name='input_17.1' id='input_1_17_1' value='' aria-required='true' /> <label for='input_1_17_1' id='input_1_17_1_label' >Street Address</label> </span><span class='ginput_full address_line_2 ginput_address_line_2' id='input_1_17_2_container' > <input type='text' name='input_17.2' id='input_1_17_2' value='' aria-required='false' /> <label for='input_1_17_2' id='input_1_17_2_label' >Address Line 2</label> </span><span class='ginput_left address_city ginput_address_city' id='input_1_17_3_container' > <input type='text' name='input_17.3' id='input_1_17_3' value='' aria-required='true' /> <label for='input_1_17_3' id='input_1_17_3_label' >City</label> </span><span class='ginput_right address_state ginput_address_state' id='input_1_17_4_container' > <input type='text' name='input_17.4' id='input_1_17_4' value='' aria-required='true' /> <label for='input_1_17_4' id='input_1_17_4_label' >State / Province / Region</label> </span><span class='ginput_left address_zip ginput_address_zip' id='input_1_17_5_container' > <input type='text' name='input_17.5' id='input_1_17_5' value='' aria-required='true' /> <label for='input_1_17_5' id='input_1_17_5_label' >ZIP / Postal Code</label> </span><span class='ginput_right address_country ginput_address_country' id='input_1_17_6_container' > <select name='input_17.6' id='input_1_17_6' aria-required='true' ><option value='' ></option><option value='Afghanistan' >Afghanistan</option><option value='Albania' >Albania</option><option value='Algeria' >Algeria</option><option value='American Samoa' >American Samoa</option><option value='Andorra' >Andorra</option><option value='Angola' >Angola</option><option value='Anguilla' >Anguilla</option><option value='Antarctica' >Antarctica</option><option value='Antigua and Barbuda' >Antigua and Barbuda</option><option value='Argentina' >Argentina</option><option value='Armenia' >Armenia</option><option value='Aruba' >Aruba</option><option value='Australia' >Australia</option><option value='Austria' >Austria</option><option value='Azerbaijan' >Azerbaijan</option><option value='Bahamas' >Bahamas</option><option value='Bahrain' >Bahrain</option><option value='Bangladesh' >Bangladesh</option><option value='Barbados' >Barbados</option><option value='Belarus' >Belarus</option><option value='Belgium' >Belgium</option><option value='Belize' >Belize</option><option value='Benin' >Benin</option><option value='Bermuda' >Bermuda</option><option value='Bhutan' >Bhutan</option><option value='Bolivia' >Bolivia</option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba</option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina</option><option value='Botswana' >Botswana</option><option value='Bouvet Island' >Bouvet Island</option><option value='Brazil' >Brazil</option><option value='British Indian Ocean Territory' >British Indian Ocean Territory</option><option value='Brunei Darussalam' >Brunei Darussalam</option><option value='Bulgaria' >Bulgaria</option><option value='Burkina Faso' >Burkina Faso</option><option value='Burundi' >Burundi</option><option value='Cambodia' >Cambodia</option><option value='Cameroon' >Cameroon</option><option value='Canada' >Canada</option><option value='Cape Verde' >Cape Verde</option><option value='Cayman Islands' >Cayman Islands</option><option value='Central African Republic' >Central African Republic</option><option value='Chad' >Chad</option><option value='Chile' >Chile</option><option value='China' >China</option><option value='Christmas Island' >Christmas Island</option><option value='Cocos Islands' >Cocos Islands</option><option value='Colombia' >Colombia</option><option value='Comoros' >Comoros</option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the</option><option value='Congo, Republic of the' >Congo, Republic of the</option><option value='Cook Islands' >Cook Islands</option><option value='Costa Rica' >Costa Rica</option><option value='Croatia' >Croatia</option><option value='Cuba' >Cuba</option><option value='Curaçao' >Curaçao</option><option value='Cyprus' >Cyprus</option><option value='Czech Republic' >Czech Republic</option><option value='Côte d&#039;Ivoire' >Côte d&#039;Ivoire</option><option value='Denmark' >Denmark</option><option value='Djibouti' >Djibouti</option><option value='Dominica' >Dominica</option><option value='Dominican Republic' >Dominican Republic</option><option value='Ecuador' >Ecuador</option><option value='Egypt' >Egypt</option><option value='El Salvador' >El Salvador</option><option value='Equatorial Guinea' >Equatorial Guinea</option><option value='Eritrea' >Eritrea</option><option value='Estonia' >Estonia</option><option value='Eswatini (Swaziland)' >Eswatini (Swaziland)</option><option value='Ethiopia' >Ethiopia</option><option value='Falkland Islands' >Falkland Islands</option><option value='Faroe Islands' >Faroe Islands</option><option value='Fiji' >Fiji</option><option value='Finland' >Finland</option><option value='France' >France</option><option value='French Guiana' >French Guiana</option><option value='French Polynesia' >French Polynesia</option><option value='French Southern Territories' >French Southern Territories</option><option value='Gabon' >Gabon</option><option value='Gambia' >Gambia</option><option value='Georgia' >Georgia</option><option value='Germany' >Germany</option><option value='Ghana' >Ghana</option><option value='Gibraltar' >Gibraltar</option><option value='Greece' >Greece</option><option value='Greenland' >Greenland</option><option value='Grenada' >Grenada</option><option value='Guadeloupe' >Guadeloupe</option><option value='Guam' >Guam</option><option value='Guatemala' >Guatemala</option><option value='Guernsey' >Guernsey</option><option value='Guinea' >Guinea</option><option value='Guinea-Bissau' >Guinea-Bissau</option><option value='Guyana' >Guyana</option><option value='Haiti' >Haiti</option><option value='Heard and McDonald Islands' >Heard and McDonald Islands</option><option value='Holy See' >Holy See</option><option value='Honduras' >Honduras</option><option value='Hong Kong' >Hong Kong</option><option value='Hungary' >Hungary</option><option value='Iceland' >Iceland</option><option value='India' >India</option><option value='Indonesia' >Indonesia</option><option value='Iran' >Iran</option><option value='Iraq' >Iraq</option><option value='Ireland' >Ireland</option><option value='Isle of Man' >Isle of Man</option><option value='Israel' >Israel</option><option value='Italy' >Italy</option><option value='Jamaica' >Jamaica</option><option value='Japan' >Japan</option><option value='Jersey' >Jersey</option><option value='Jordan' >Jordan</option><option value='Kazakhstan' >Kazakhstan</option><option value='Kenya' >Kenya</option><option value='Kiribati' >Kiribati</option><option value='Kuwait' >Kuwait</option><option value='Kyrgyzstan' >Kyrgyzstan</option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic</option><option value='Latvia' >Latvia</option><option value='Lebanon' >Lebanon</option><option value='Lesotho' >Lesotho</option><option value='Liberia' >Liberia</option><option value='Libya' >Libya</option><option value='Liechtenstein' >Liechtenstein</option><option value='Lithuania' >Lithuania</option><option value='Luxembourg' >Luxembourg</option><option value='Macau' >Macau</option><option value='Macedonia' >Macedonia</option><option value='Madagascar' >Madagascar</option><option value='Malawi' >Malawi</option><option value='Malaysia' >Malaysia</option><option value='Maldives' >Maldives</option><option value='Mali' >Mali</option><option value='Malta' >Malta</option><option value='Marshall Islands' >Marshall Islands</option><option value='Martinique' >Martinique</option><option value='Mauritania' >Mauritania</option><option value='Mauritius' >Mauritius</option><option value='Mayotte' >Mayotte</option><option value='Mexico' >Mexico</option><option value='Micronesia' >Micronesia</option><option value='Moldova' >Moldova</option><option value='Monaco' >Monaco</option><option value='Mongolia' >Mongolia</option><option value='Montenegro' >Montenegro</option><option value='Montserrat' >Montserrat</option><option value='Morocco' >Morocco</option><option value='Mozambique' >Mozambique</option><option value='Myanmar' >Myanmar</option><option value='Namibia' >Namibia</option><option value='Nauru' >Nauru</option><option value='Nepal' >Nepal</option><option value='Netherlands' >Netherlands</option><option value='New Caledonia' >New Caledonia</option><option value='New Zealand' >New Zealand</option><option value='Nicaragua' >Nicaragua</option><option value='Niger' >Niger</option><option value='Nigeria' >Nigeria</option><option value='Niue' >Niue</option><option value='Norfolk Island' >Norfolk Island</option><option value='North Korea' >North Korea</option><option value='Northern Mariana Islands' >Northern Mariana Islands</option><option value='Norway' >Norway</option><option value='Oman' >Oman</option><option value='Pakistan' >Pakistan</option><option value='Palau' >Palau</option><option value='Palestine, State of' >Palestine, State of</option><option value='Panama' >Panama</option><option value='Papua New Guinea' >Papua New Guinea</option><option value='Paraguay' >Paraguay</option><option value='Peru' >Peru</option><option value='Philippines' >Philippines</option><option value='Pitcairn' >Pitcairn</option><option value='Poland' >Poland</option><option value='Portugal' >Portugal</option><option value='Puerto Rico' >Puerto Rico</option><option value='Qatar' >Qatar</option><option value='Romania' >Romania</option><option value='Russia' >Russia</option><option value='Rwanda' >Rwanda</option><option value='Réunion' >Réunion</option><option value='Saint Barthélemy' >Saint Barthélemy</option><option value='Saint Helena' >Saint Helena</option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis</option><option value='Saint Lucia' >Saint Lucia</option><option value='Saint Martin' >Saint Martin</option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon</option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines</option><option value='Samoa' >Samoa</option><option value='San Marino' >San Marino</option><option value='Sao Tome and Principe' >Sao Tome and Principe</option><option value='Saudi Arabia' >Saudi Arabia</option><option value='Senegal' >Senegal</option><option value='Serbia' >Serbia</option><option value='Seychelles' >Seychelles</option><option value='Sierra Leone' >Sierra Leone</option><option value='Singapore' >Singapore</option><option value='Sint Maarten' >Sint Maarten</option><option value='Slovakia' >Slovakia</option><option value='Slovenia' >Slovenia</option><option value='Solomon Islands' >Solomon Islands</option><option value='Somalia' >Somalia</option><option value='South Africa' >South Africa</option><option value='South Georgia' >South Georgia</option><option value='South Korea' >South Korea</option><option value='South Sudan' >South Sudan</option><option value='Spain' >Spain</option><option value='Sri Lanka' >Sri Lanka</option><option value='Sudan' >Sudan</option><option value='Suriname' >Suriname</option><option value='Svalbard and Jan Mayen Islands' >Svalbard and Jan Mayen Islands</option><option value='Sweden' >Sweden</option><option value='Switzerland' >Switzerland</option><option value='Syria' >Syria</option><option value='Taiwan' >Taiwan</option><option value='Tajikistan' >Tajikistan</option><option value='Tanzania' >Tanzania</option><option value='Thailand' >Thailand</option><option value='Timor-Leste' >Timor-Leste</option><option value='Togo' >Togo</option><option value='Tokelau' >Tokelau</option><option value='Tonga' >Tonga</option><option value='Trinidad and Tobago' >Trinidad and Tobago</option><option value='Tunisia' >Tunisia</option><option value='Turkey' >Turkey</option><option value='Turkmenistan' >Turkmenistan</option><option value='Turks and Caicos Islands' >Turks and Caicos Islands</option><option value='Tuvalu' >Tuvalu</option><option value='US Minor Outlying Islands' >US Minor Outlying Islands</option><option value='Uganda' >Uganda</option><option value='Ukraine' >Ukraine</option><option value='United Arab Emirates' >United Arab Emirates</option><option value='United Kingdom' >United Kingdom</option><option value='United States' selected='selected'>United States</option><option value='Uruguay' >Uruguay</option><option value='Uzbekistan' >Uzbekistan</option><option value='Vanuatu' >Vanuatu</option><option value='Venezuela' >Venezuela</option><option value='Vietnam' >Vietnam</option><option value='Virgin Islands, British' >Virgin Islands, British</option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.</option><option value='Wallis and Futuna' >Wallis and Futuna</option><option value='Western Sahara' >Western Sahara</option><option value='Yemen' >Yemen</option><option value='Zambia' >Zambia</option><option value='Zimbabwe' >Zimbabwe</option><option value='Åland Islands' >Åland Islands</option></select> <label for='input_1_17_6' id='input_1_17_6_label' >Country</label> </span> <div class='gf_clear gf_clear_complex'></div> </div></li><li id="field_1_20" class="gfield gsection field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_20"><h2 class="gsection_title"></h2></li><li id="field_1_14" class="gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_14"><label class='gfield_label gfield_label_before_complex' >Are you of Hispanic/Latino/Spanish origin?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_1_14'><li class='gchoice gchoice_1_14_1'> <input class='gfield-choice-input' name='input_14.1' type='checkbox' value='Yes' id='choice_1_14_1' /> <label for='choice_1_14_1' id='label_1_14_1'>Yes</label> </li><li class='gchoice gchoice_1_14_2'> <input class='gfield-choice-input' name='input_14.2' type='checkbox' value='No' id='choice_1_14_2' /> <label for='choice_1_14_2' id='label_1_14_2'>No</label> 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gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_18"><label class='gfield_label gfield_label_before_complex' >Terms &amp; Conditions<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_consent'><input name='input_18.1' id='input_1_18_1' type='checkbox' value='1' aria-describedby="gfield_consent_description_1_18 gfield_description_1_18" aria-required="true" aria-invalid="false" /> <label class="gfield_consent_label" for='input_1_18_1' >I understand and acknowledge that by checking the box below, I am legally agreeing to all of the statements listed below.</label><input type='hidden' name='input_18.2' value='I understand and acknowledge that by checking the box below, I am legally agreeing to all of the statements listed below.' class='gform_hidden' /><input type='hidden' name='input_18.3' value='6' class='gform_hidden' /></div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_1_18'>By registering for this Gateway to Hope (GTH) training, the user acknowledges and agrees to all terms and conditions stated herein. All copyrights, trademarks, content, business methods, graphics, designs and documents posted on this website, as well as the look and feel of this website ("Intellectual Property") are the property of the Hope and Healing Center & Institute.<br /> <br /> The user may download one copy of the materials on any single computer and print a copy of the materials solely for use in learning about or utilizing Gateway to Hope's training materials and resources. The user may not otherwise copy, print, reproduce, distribute, transmit, upload, download, store, use, or change the materials. All such materials are copyrighted by the Hope and Healing Center & Institute.</div></li><li id="field_1_13" class="gfield gsection field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_13"><h2 class="gsection_title"></h2></li><li id="field_1_9" class="gfield field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_1_9"><label class='gfield_label gfield_label_before_complex' >Newsletter Optin</label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_1_9'><li class='gchoice gchoice_1_9_1'> <input class='gfield-choice-input' name='input_9.1' type='checkbox' value='Please sign me up for updates, insights, resources, and more.' checked='checked' id='choice_1_9_1' /> <label for='choice_1_9_1' id='label_1_9_1'>Please sign me up for updates, insights, resources, and more.</label> </li></ul></div></li><li id="field_1_22" class="gfield gform_validation_container field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_22"><label class='gfield_label' for='input_1_22' >Phone</label><div class='ginput_container'><input name='input_22' id='input_1_22' type='text' value='' autocomplete='new-password'/></div><div class='gfield_description' id='gfield_description_1_22'>This field is for validation purposes and should be left unchanged.</div></li></ul></div> <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_1' class='gform_button button' value='Submit' onclick='if(window["gf_submitting_1"]){return false;} if( !jQuery("#gform_1")[0].checkValidity || jQuery("#gform_1")[0].checkValidity()){window["gf_submitting_1"]=true;} ' onkeypress='if( event.keyCode == 13 ){ if(window["gf_submitting_1"]){return false;} if( !jQuery("#gform_1")[0].checkValidity || jQuery("#gform_1")[0].checkValidity()){window["gf_submitting_1"]=true;} jQuery("#gform_1").trigger("submit",[true]); }' /> <input type='hidden' class='gform_hidden' name='is_submit_1' value='1' /> <input type='hidden' class='gform_hidden' name='gform_submit' value='1' /> <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' /> <input type='hidden' class='gform_hidden' name='state_1' value='WyJ7XCIxOC4xXCI6XCI4ZWVjNjNkZDZhMDFjYjE5MjEyMzliY2M5YWNkNmNlMVwiLFwiMTguMlwiOlwiOTA2YWZlM2IyN2U5ZDFjYTQ4NmFkOGM4YmE3YWZlMzlcIixcIjE4LjNcIjpcImY4MGQwNTNlMzUwZjU5ZDM3M2M2YzJlZTc5ODViMzY2XCJ9IiwiZjI0MDg4NjhmY2IxNWYxMTZhN2QxYmJjNTk4YzAwNWYiXQ==' /> <input type='hidden' class='gform_hidden' name='gform_target_page_number_1' id='gform_target_page_number_1' value='0' /> <input type='hidden' class='gform_hidden' name='gform_source_page_number_1' id='gform_source_page_number_1' value='1' /> <input type='hidden' name='gform_field_values' value='' /> </div> <input type="hidden" id="ct_checkjs_1aa48fc4880bb0c9b8a3bf979d3b917e" name="ct_checkjs" value="0" /><script type="text/javascript" >setTimeout(function(){var ct_input_name = "ct_checkjs_1aa48fc4880bb0c9b8a3bf979d3b917e";if (document.getElementById(ct_input_name) !== null) {var ct_input_value = document.getElementById(ct_input_name).value;document.getElementById(ct_input_name).value = document.getElementById(ct_input_name).value.replace(ct_input_value, 'daff13625f026def51775140059231ba46d5adca1056f439641605167e8402c2');}}, 1000);</script></form> </div>
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<div class='gf_browser_unknown gform_wrapper gform_legacy_markup_wrapper' id='gform_wrapper_1' > <div class='gform_heading'> <h3 class="gform_title">EMPOWER Online Training Registration</h3> <span class='gform_description'></span> </div><form method='post' enctype='multipart/form-data' id='gform_1' action='/event/family-connections-understanding-borderline-personality-disorder-finding-compassion-support-intense-emotions-impact-ones-love/' novalidate> <div class='gform_body gform-body'><ul id='gform_fields_1' class='gform_fields top_label form_sublabel_below description_below'><li id="field_1_1" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_1"><label class='gfield_label gfield_label_before_complex' >Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_1_1'> <span id='input_1_1_3_container' class='name_first' > <input type='text' name='input_1.3' id='input_1_1_3' value='' aria-required='true' /> <label for='input_1_1_3' >First</label> </span> <span id='input_1_1_6_container' class='name_last' > <input type='text' name='input_1.6' id='input_1_1_6' value='' aria-required='true' /> <label for='input_1_1_6' >Last</label> </span> </div></li><li id="field_1_2" class="gfield gf_left_half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_2"><label class='gfield_label' for='input_1_2' >Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'> <input name='input_2' id='input_1_2' type='email' value='' class='medium' aria-required="true" aria-invalid="false" /> </div></li><li id="field_1_3" class="gfield gf_right_half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_3"><label class='gfield_label' for='input_1_3' >Phone<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_1_3' type='tel' value='' class='medium' aria-required="true" aria-invalid="false" /></div></li><li id="field_1_4" class="gfield gfield--width-full gf_left_half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_4"><label class='gfield_label' for='input_1_4' >Company / Organization<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_1_4' type='text' value='' class='medium' aria-required="true" aria-invalid="false" /> </div></li><li id="field_1_7" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_7"><label class='gfield_label gfield_label_before_complex' >Password<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_complex ginput_container ginput_container_password' id='input_1_7_container'> <span id='input_1_7_1_container' class='ginput_left'> <span class='password_input_container'> <input type='password' name='input_7' id='input_1_7' value='' aria-required="true" aria-invalid="false" /> </span> <label for='input_1_7' >Enter Password</label> </span> <span id='input_1_7_2_container' class='ginput_right'> <span class='password_input_container'> <input type='password' name='input_7_2' id='input_1_7_2' value='' aria-required="true" aria-invalid="false" /> </span> <label for='input_1_7_2' >Confirm Password</label> </span> <div class='gf_clear gf_clear_complex'></div> </div></li><li id="field_1_19" class="gfield gsection field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_19"><h2 class="gsection_title"></h2></li><li id="field_1_16" class="gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_16"><label class='gfield_label gfield_label_before_complex' >Home Address<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label> <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address' id='input_1_16' > <span class='ginput_full address_line_1 ginput_address_line_1' id='input_1_16_1_container' > <input type='text' name='input_16.1' id='input_1_16_1' value='' aria-required='true' /> <label for='input_1_16_1' id='input_1_16_1_label' >Street Address</label> </span><span class='ginput_full address_line_2 ginput_address_line_2' id='input_1_16_2_container' > <input type='text' name='input_16.2' id='input_1_16_2' value='' aria-required='false' /> <label for='input_1_16_2' id='input_1_16_2_label' >Address Line 2</label> </span><span class='ginput_left address_city ginput_address_city' id='input_1_16_3_container' > <input type='text' name='input_16.3' id='input_1_16_3' value='' aria-required='true' /> <label for='input_1_16_3' id='input_1_16_3_label' >City</label> </span><span class='ginput_right address_state ginput_address_state' id='input_1_16_4_container' > <input type='text' name='input_16.4' id='input_1_16_4' value='' aria-required='true' /> <label for='input_1_16_4' id='input_1_16_4_label' >State / Province / Region</label> </span><span class='ginput_left address_zip ginput_address_zip' id='input_1_16_5_container' > <input type='text' name='input_16.5' id='input_1_16_5' value='' aria-required='true' /> <label for='input_1_16_5' id='input_1_16_5_label' >ZIP / Postal Code</label> </span><span class='ginput_right address_country ginput_address_country' id='input_1_16_6_container' > <select name='input_16.6' id='input_1_16_6' aria-required='true' ><option value='' ></option><option value='Afghanistan' >Afghanistan</option><option value='Albania' >Albania</option><option value='Algeria' >Algeria</option><option value='American Samoa' >American Samoa</option><option value='Andorra' >Andorra</option><option value='Angola' >Angola</option><option value='Anguilla' >Anguilla</option><option value='Antarctica' >Antarctica</option><option value='Antigua and Barbuda' >Antigua and Barbuda</option><option value='Argentina' >Argentina</option><option value='Armenia' >Armenia</option><option value='Aruba' >Aruba</option><option value='Australia' >Australia</option><option value='Austria' >Austria</option><option value='Azerbaijan' >Azerbaijan</option><option value='Bahamas' >Bahamas</option><option value='Bahrain' >Bahrain</option><option value='Bangladesh' >Bangladesh</option><option value='Barbados' >Barbados</option><option value='Belarus' >Belarus</option><option value='Belgium' >Belgium</option><option value='Belize' >Belize</option><option value='Benin' >Benin</option><option value='Bermuda' >Bermuda</option><option value='Bhutan' >Bhutan</option><option value='Bolivia' >Bolivia</option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba</option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina</option><option value='Botswana' >Botswana</option><option value='Bouvet Island' >Bouvet Island</option><option value='Brazil' >Brazil</option><option value='British Indian Ocean Territory' >British Indian Ocean Territory</option><option value='Brunei Darussalam' >Brunei Darussalam</option><option value='Bulgaria' >Bulgaria</option><option value='Burkina Faso' >Burkina Faso</option><option value='Burundi' >Burundi</option><option value='Cambodia' >Cambodia</option><option value='Cameroon' >Cameroon</option><option value='Canada' >Canada</option><option value='Cape Verde' >Cape Verde</option><option value='Cayman Islands' >Cayman Islands</option><option value='Central African Republic' >Central African Republic</option><option value='Chad' >Chad</option><option value='Chile' >Chile</option><option value='China' >China</option><option value='Christmas Island' >Christmas Island</option><option value='Cocos Islands' >Cocos Islands</option><option value='Colombia' >Colombia</option><option value='Comoros' >Comoros</option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the</option><option value='Congo, Republic of the' >Congo, Republic of the</option><option value='Cook Islands' >Cook Islands</option><option value='Costa Rica' >Costa Rica</option><option value='Croatia' >Croatia</option><option value='Cuba' >Cuba</option><option value='Curaçao' >Curaçao</option><option value='Cyprus' >Cyprus</option><option value='Czech Republic' >Czech Republic</option><option value='Côte d&#039;Ivoire' >Côte d&#039;Ivoire</option><option value='Denmark' >Denmark</option><option value='Djibouti' >Djibouti</option><option value='Dominica' >Dominica</option><option value='Dominican Republic' >Dominican Republic</option><option value='Ecuador' >Ecuador</option><option value='Egypt' >Egypt</option><option value='El Salvador' >El Salvador</option><option value='Equatorial Guinea' >Equatorial Guinea</option><option value='Eritrea' >Eritrea</option><option value='Estonia' >Estonia</option><option value='Eswatini (Swaziland)' >Eswatini (Swaziland)</option><option value='Ethiopia' >Ethiopia</option><option value='Falkland Islands' >Falkland Islands</option><option value='Faroe Islands' >Faroe Islands</option><option value='Fiji' >Fiji</option><option value='Finland' >Finland</option><option value='France' >France</option><option value='French Guiana' >French Guiana</option><option value='French Polynesia' >French Polynesia</option><option value='French Southern Territories' >French Southern Territories</option><option value='Gabon' >Gabon</option><option value='Gambia' >Gambia</option><option value='Georgia' >Georgia</option><option value='Germany' >Germany</option><option value='Ghana' >Ghana</option><option value='Gibraltar' >Gibraltar</option><option value='Greece' >Greece</option><option value='Greenland' >Greenland</option><option value='Grenada' >Grenada</option><option value='Guadeloupe' >Guadeloupe</option><option value='Guam' >Guam</option><option value='Guatemala' >Guatemala</option><option value='Guernsey' >Guernsey</option><option value='Guinea' >Guinea</option><option value='Guinea-Bissau' >Guinea-Bissau</option><option value='Guyana' >Guyana</option><option value='Haiti' >Haiti</option><option value='Heard and McDonald Islands' >Heard and McDonald Islands</option><option value='Holy See' >Holy See</option><option value='Honduras' >Honduras</option><option value='Hong Kong' >Hong Kong</option><option value='Hungary' >Hungary</option><option value='Iceland' >Iceland</option><option value='India' >India</option><option value='Indonesia' >Indonesia</option><option value='Iran' >Iran</option><option value='Iraq' >Iraq</option><option value='Ireland' >Ireland</option><option value='Isle of Man' >Isle of Man</option><option value='Israel' >Israel</option><option value='Italy' >Italy</option><option value='Jamaica' >Jamaica</option><option value='Japan' >Japan</option><option value='Jersey' >Jersey</option><option value='Jordan' >Jordan</option><option value='Kazakhstan' >Kazakhstan</option><option value='Kenya' >Kenya</option><option value='Kiribati' >Kiribati</option><option value='Kuwait' >Kuwait</option><option value='Kyrgyzstan' >Kyrgyzstan</option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic</option><option value='Latvia' >Latvia</option><option value='Lebanon' >Lebanon</option><option value='Lesotho' >Lesotho</option><option value='Liberia' >Liberia</option><option value='Libya' >Libya</option><option value='Liechtenstein' >Liechtenstein</option><option value='Lithuania' >Lithuania</option><option value='Luxembourg' >Luxembourg</option><option value='Macau' >Macau</option><option value='Macedonia' >Macedonia</option><option value='Madagascar' >Madagascar</option><option value='Malawi' >Malawi</option><option value='Malaysia' >Malaysia</option><option value='Maldives' >Maldives</option><option value='Mali' >Mali</option><option value='Malta' >Malta</option><option value='Marshall Islands' >Marshall Islands</option><option value='Martinique' >Martinique</option><option value='Mauritania' >Mauritania</option><option value='Mauritius' >Mauritius</option><option value='Mayotte' >Mayotte</option><option value='Mexico' >Mexico</option><option value='Micronesia' >Micronesia</option><option value='Moldova' >Moldova</option><option value='Monaco' >Monaco</option><option value='Mongolia' >Mongolia</option><option value='Montenegro' >Montenegro</option><option value='Montserrat' >Montserrat</option><option value='Morocco' >Morocco</option><option value='Mozambique' >Mozambique</option><option value='Myanmar' >Myanmar</option><option value='Namibia' >Namibia</option><option value='Nauru' >Nauru</option><option value='Nepal' >Nepal</option><option value='Netherlands' >Netherlands</option><option value='New Caledonia' >New Caledonia</option><option value='New Zealand' >New Zealand</option><option value='Nicaragua' >Nicaragua</option><option value='Niger' >Niger</option><option value='Nigeria' >Nigeria</option><option value='Niue' >Niue</option><option value='Norfolk Island' >Norfolk Island</option><option value='North Korea' >North Korea</option><option value='Northern Mariana Islands' >Northern Mariana Islands</option><option value='Norway' >Norway</option><option value='Oman' >Oman</option><option value='Pakistan' >Pakistan</option><option value='Palau' >Palau</option><option value='Palestine, State of' >Palestine, State of</option><option value='Panama' >Panama</option><option value='Papua New Guinea' >Papua New Guinea</option><option value='Paraguay' >Paraguay</option><option value='Peru' >Peru</option><option value='Philippines' >Philippines</option><option value='Pitcairn' >Pitcairn</option><option value='Poland' >Poland</option><option value='Portugal' >Portugal</option><option value='Puerto Rico' >Puerto Rico</option><option value='Qatar' >Qatar</option><option value='Romania' >Romania</option><option value='Russia' >Russia</option><option value='Rwanda' >Rwanda</option><option value='Réunion' >Réunion</option><option value='Saint Barthélemy' >Saint Barthélemy</option><option value='Saint Helena' >Saint Helena</option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis</option><option value='Saint Lucia' >Saint Lucia</option><option value='Saint Martin' >Saint Martin</option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon</option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines</option><option value='Samoa' >Samoa</option><option value='San Marino' >San Marino</option><option value='Sao Tome and Principe' >Sao Tome and Principe</option><option value='Saudi Arabia' >Saudi Arabia</option><option value='Senegal' >Senegal</option><option value='Serbia' >Serbia</option><option value='Seychelles' >Seychelles</option><option value='Sierra Leone' >Sierra Leone</option><option value='Singapore' >Singapore</option><option value='Sint Maarten' >Sint Maarten</option><option value='Slovakia' >Slovakia</option><option value='Slovenia' >Slovenia</option><option value='Solomon Islands' >Solomon Islands</option><option value='Somalia' >Somalia</option><option value='South Africa' >South Africa</option><option value='South Georgia' >South Georgia</option><option value='South Korea' >South Korea</option><option value='South Sudan' >South Sudan</option><option value='Spain' >Spain</option><option value='Sri Lanka' >Sri Lanka</option><option value='Sudan' >Sudan</option><option value='Suriname' >Suriname</option><option value='Svalbard and Jan Mayen Islands' >Svalbard and Jan Mayen Islands</option><option value='Sweden' >Sweden</option><option value='Switzerland' >Switzerland</option><option value='Syria' >Syria</option><option value='Taiwan' >Taiwan</option><option value='Tajikistan' >Tajikistan</option><option value='Tanzania' >Tanzania</option><option value='Thailand' >Thailand</option><option value='Timor-Leste' >Timor-Leste</option><option value='Togo' >Togo</option><option value='Tokelau' >Tokelau</option><option value='Tonga' >Tonga</option><option value='Trinidad and Tobago' >Trinidad and Tobago</option><option value='Tunisia' >Tunisia</option><option value='Turkey' >Turkey</option><option value='Turkmenistan' >Turkmenistan</option><option value='Turks and Caicos Islands' >Turks and Caicos Islands</option><option value='Tuvalu' >Tuvalu</option><option value='US Minor Outlying Islands' >US Minor Outlying Islands</option><option value='Uganda' >Uganda</option><option value='Ukraine' >Ukraine</option><option value='United Arab Emirates' >United Arab Emirates</option><option value='United Kingdom' >United Kingdom</option><option value='United States' selected='selected'>United States</option><option value='Uruguay' >Uruguay</option><option value='Uzbekistan' >Uzbekistan</option><option value='Vanuatu' >Vanuatu</option><option value='Venezuela' >Venezuela</option><option value='Vietnam' >Vietnam</option><option value='Virgin Islands, British' >Virgin Islands, British</option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.</option><option value='Wallis and Futuna' >Wallis and Futuna</option><option value='Western Sahara' >Western Sahara</option><option value='Yemen' >Yemen</option><option value='Zambia' >Zambia</option><option value='Zimbabwe' >Zimbabwe</option><option value='Åland Islands' >Åland Islands</option></select> <label for='input_1_16_6' id='input_1_16_6_label' >Country</label> </span> <div class='gf_clear gf_clear_complex'></div> </div></li><li id="field_1_17" class="gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_17"><label class='gfield_label gfield_label_before_complex' >Work Address<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label> <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address' id='input_1_17' > <span class='ginput_full address_line_1 ginput_address_line_1' id='input_1_17_1_container' > <input type='text' name='input_17.1' id='input_1_17_1' value='' aria-required='true' /> <label for='input_1_17_1' id='input_1_17_1_label' >Street Address</label> </span><span class='ginput_full address_line_2 ginput_address_line_2' id='input_1_17_2_container' > <input type='text' name='input_17.2' id='input_1_17_2' value='' aria-required='false' /> <label for='input_1_17_2' id='input_1_17_2_label' >Address Line 2</label> </span><span class='ginput_left address_city ginput_address_city' id='input_1_17_3_container' > <input type='text' name='input_17.3' id='input_1_17_3' value='' aria-required='true' /> <label for='input_1_17_3' id='input_1_17_3_label' >City</label> </span><span class='ginput_right address_state ginput_address_state' id='input_1_17_4_container' > <input type='text' name='input_17.4' id='input_1_17_4' value='' aria-required='true' /> <label for='input_1_17_4' id='input_1_17_4_label' >State / Province / Region</label> </span><span class='ginput_left address_zip ginput_address_zip' id='input_1_17_5_container' > <input type='text' name='input_17.5' id='input_1_17_5' value='' aria-required='true' /> <label for='input_1_17_5' id='input_1_17_5_label' >ZIP / Postal Code</label> </span><span class='ginput_right address_country ginput_address_country' id='input_1_17_6_container' > <select name='input_17.6' id='input_1_17_6' aria-required='true' ><option value='' ></option><option value='Afghanistan' >Afghanistan</option><option value='Albania' >Albania</option><option value='Algeria' >Algeria</option><option value='American Samoa' >American Samoa</option><option value='Andorra' >Andorra</option><option value='Angola' >Angola</option><option value='Anguilla' >Anguilla</option><option value='Antarctica' >Antarctica</option><option value='Antigua and Barbuda' >Antigua and Barbuda</option><option value='Argentina' >Argentina</option><option value='Armenia' >Armenia</option><option value='Aruba' >Aruba</option><option value='Australia' >Australia</option><option value='Austria' >Austria</option><option value='Azerbaijan' >Azerbaijan</option><option value='Bahamas' >Bahamas</option><option value='Bahrain' >Bahrain</option><option value='Bangladesh' >Bangladesh</option><option value='Barbados' >Barbados</option><option value='Belarus' >Belarus</option><option value='Belgium' >Belgium</option><option value='Belize' >Belize</option><option value='Benin' >Benin</option><option value='Bermuda' >Bermuda</option><option value='Bhutan' >Bhutan</option><option value='Bolivia' >Bolivia</option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba</option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina</option><option value='Botswana' >Botswana</option><option value='Bouvet Island' >Bouvet Island</option><option value='Brazil' >Brazil</option><option value='British Indian Ocean Territory' >British Indian Ocean Territory</option><option value='Brunei Darussalam' >Brunei Darussalam</option><option value='Bulgaria' >Bulgaria</option><option value='Burkina Faso' >Burkina Faso</option><option value='Burundi' >Burundi</option><option value='Cambodia' >Cambodia</option><option value='Cameroon' >Cameroon</option><option value='Canada' >Canada</option><option value='Cape Verde' >Cape Verde</option><option value='Cayman Islands' >Cayman Islands</option><option value='Central African Republic' >Central African Republic</option><option value='Chad' >Chad</option><option value='Chile' >Chile</option><option value='China' >China</option><option value='Christmas Island' >Christmas Island</option><option value='Cocos Islands' >Cocos Islands</option><option value='Colombia' >Colombia</option><option value='Comoros' >Comoros</option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the</option><option value='Congo, Republic of the' >Congo, Republic of the</option><option value='Cook Islands' >Cook Islands</option><option value='Costa Rica' >Costa Rica</option><option value='Croatia' >Croatia</option><option value='Cuba' >Cuba</option><option value='Curaçao' >Curaçao</option><option value='Cyprus' >Cyprus</option><option value='Czech Republic' >Czech Republic</option><option value='Côte d&#039;Ivoire' >Côte d&#039;Ivoire</option><option value='Denmark' >Denmark</option><option value='Djibouti' >Djibouti</option><option value='Dominica' >Dominica</option><option value='Dominican Republic' >Dominican Republic</option><option value='Ecuador' >Ecuador</option><option value='Egypt' >Egypt</option><option value='El Salvador' >El Salvador</option><option value='Equatorial Guinea' >Equatorial Guinea</option><option value='Eritrea' >Eritrea</option><option value='Estonia' >Estonia</option><option value='Eswatini (Swaziland)' >Eswatini (Swaziland)</option><option value='Ethiopia' >Ethiopia</option><option value='Falkland Islands' >Falkland Islands</option><option value='Faroe Islands' >Faroe Islands</option><option value='Fiji' >Fiji</option><option value='Finland' >Finland</option><option value='France' >France</option><option value='French Guiana' >French Guiana</option><option value='French Polynesia' >French Polynesia</option><option value='French Southern Territories' >French Southern Territories</option><option value='Gabon' >Gabon</option><option value='Gambia' >Gambia</option><option value='Georgia' >Georgia</option><option value='Germany' >Germany</option><option value='Ghana' >Ghana</option><option value='Gibraltar' >Gibraltar</option><option value='Greece' >Greece</option><option value='Greenland' >Greenland</option><option value='Grenada' >Grenada</option><option value='Guadeloupe' >Guadeloupe</option><option value='Guam' >Guam</option><option value='Guatemala' >Guatemala</option><option value='Guernsey' >Guernsey</option><option value='Guinea' >Guinea</option><option value='Guinea-Bissau' >Guinea-Bissau</option><option value='Guyana' >Guyana</option><option value='Haiti' >Haiti</option><option value='Heard and McDonald Islands' >Heard and McDonald Islands</option><option value='Holy See' >Holy See</option><option value='Honduras' >Honduras</option><option value='Hong Kong' >Hong Kong</option><option value='Hungary' >Hungary</option><option value='Iceland' >Iceland</option><option value='India' >India</option><option value='Indonesia' >Indonesia</option><option value='Iran' >Iran</option><option value='Iraq' >Iraq</option><option value='Ireland' >Ireland</option><option value='Isle of Man' >Isle of Man</option><option value='Israel' >Israel</option><option value='Italy' >Italy</option><option value='Jamaica' >Jamaica</option><option value='Japan' >Japan</option><option value='Jersey' >Jersey</option><option value='Jordan' >Jordan</option><option value='Kazakhstan' >Kazakhstan</option><option value='Kenya' >Kenya</option><option value='Kiribati' >Kiribati</option><option value='Kuwait' >Kuwait</option><option value='Kyrgyzstan' >Kyrgyzstan</option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic</option><option value='Latvia' >Latvia</option><option value='Lebanon' >Lebanon</option><option value='Lesotho' >Lesotho</option><option value='Liberia' >Liberia</option><option value='Libya' >Libya</option><option value='Liechtenstein' >Liechtenstein</option><option value='Lithuania' >Lithuania</option><option value='Luxembourg' >Luxembourg</option><option value='Macau' >Macau</option><option value='Macedonia' >Macedonia</option><option value='Madagascar' >Madagascar</option><option value='Malawi' >Malawi</option><option value='Malaysia' >Malaysia</option><option value='Maldives' >Maldives</option><option value='Mali' >Mali</option><option value='Malta' >Malta</option><option value='Marshall Islands' >Marshall Islands</option><option value='Martinique' >Martinique</option><option value='Mauritania' >Mauritania</option><option value='Mauritius' >Mauritius</option><option value='Mayotte' >Mayotte</option><option value='Mexico' >Mexico</option><option value='Micronesia' >Micronesia</option><option value='Moldova' >Moldova</option><option value='Monaco' >Monaco</option><option value='Mongolia' >Mongolia</option><option value='Montenegro' >Montenegro</option><option value='Montserrat' >Montserrat</option><option value='Morocco' >Morocco</option><option value='Mozambique' >Mozambique</option><option value='Myanmar' >Myanmar</option><option value='Namibia' >Namibia</option><option value='Nauru' >Nauru</option><option value='Nepal' >Nepal</option><option value='Netherlands' >Netherlands</option><option value='New Caledonia' >New Caledonia</option><option value='New Zealand' >New Zealand</option><option value='Nicaragua' >Nicaragua</option><option value='Niger' >Niger</option><option value='Nigeria' >Nigeria</option><option value='Niue' >Niue</option><option value='Norfolk Island' >Norfolk Island</option><option value='North Korea' >North Korea</option><option value='Northern Mariana Islands' >Northern Mariana Islands</option><option value='Norway' >Norway</option><option value='Oman' >Oman</option><option value='Pakistan' >Pakistan</option><option value='Palau' >Palau</option><option value='Palestine, State of' >Palestine, State of</option><option value='Panama' >Panama</option><option value='Papua New Guinea' >Papua New Guinea</option><option value='Paraguay' >Paraguay</option><option value='Peru' >Peru</option><option value='Philippines' >Philippines</option><option value='Pitcairn' >Pitcairn</option><option value='Poland' >Poland</option><option value='Portugal' >Portugal</option><option value='Puerto Rico' >Puerto Rico</option><option value='Qatar' >Qatar</option><option value='Romania' >Romania</option><option value='Russia' >Russia</option><option value='Rwanda' >Rwanda</option><option value='Réunion' >Réunion</option><option value='Saint Barthélemy' >Saint Barthélemy</option><option value='Saint Helena' >Saint Helena</option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis</option><option value='Saint Lucia' >Saint Lucia</option><option value='Saint Martin' >Saint Martin</option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon</option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines</option><option value='Samoa' >Samoa</option><option value='San Marino' >San Marino</option><option value='Sao Tome and Principe' >Sao Tome and Principe</option><option value='Saudi Arabia' >Saudi Arabia</option><option value='Senegal' >Senegal</option><option value='Serbia' >Serbia</option><option value='Seychelles' >Seychelles</option><option value='Sierra Leone' >Sierra Leone</option><option value='Singapore' >Singapore</option><option value='Sint Maarten' >Sint Maarten</option><option value='Slovakia' >Slovakia</option><option value='Slovenia' >Slovenia</option><option value='Solomon Islands' >Solomon Islands</option><option value='Somalia' >Somalia</option><option value='South Africa' >South Africa</option><option value='South Georgia' >South Georgia</option><option value='South Korea' >South Korea</option><option value='South Sudan' >South Sudan</option><option value='Spain' >Spain</option><option value='Sri Lanka' >Sri Lanka</option><option value='Sudan' >Sudan</option><option value='Suriname' >Suriname</option><option value='Svalbard and Jan Mayen Islands' >Svalbard and Jan Mayen Islands</option><option value='Sweden' >Sweden</option><option value='Switzerland' >Switzerland</option><option value='Syria' >Syria</option><option value='Taiwan' >Taiwan</option><option value='Tajikistan' >Tajikistan</option><option value='Tanzania' >Tanzania</option><option value='Thailand' >Thailand</option><option value='Timor-Leste' >Timor-Leste</option><option value='Togo' >Togo</option><option value='Tokelau' >Tokelau</option><option value='Tonga' >Tonga</option><option value='Trinidad and Tobago' >Trinidad and Tobago</option><option value='Tunisia' >Tunisia</option><option value='Turkey' >Turkey</option><option value='Turkmenistan' >Turkmenistan</option><option value='Turks and Caicos Islands' >Turks and Caicos Islands</option><option value='Tuvalu' >Tuvalu</option><option value='US Minor Outlying Islands' >US Minor Outlying Islands</option><option value='Uganda' >Uganda</option><option value='Ukraine' >Ukraine</option><option value='United Arab Emirates' >United Arab Emirates</option><option value='United Kingdom' >United Kingdom</option><option value='United States' selected='selected'>United States</option><option value='Uruguay' >Uruguay</option><option value='Uzbekistan' >Uzbekistan</option><option value='Vanuatu' >Vanuatu</option><option value='Venezuela' >Venezuela</option><option value='Vietnam' >Vietnam</option><option value='Virgin Islands, British' >Virgin Islands, British</option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.</option><option value='Wallis and Futuna' >Wallis and Futuna</option><option value='Western Sahara' >Western Sahara</option><option value='Yemen' >Yemen</option><option value='Zambia' >Zambia</option><option value='Zimbabwe' >Zimbabwe</option><option value='Åland Islands' >Åland Islands</option></select> <label for='input_1_17_6' id='input_1_17_6_label' >Country</label> </span> <div class='gf_clear gf_clear_complex'></div> </div></li><li id="field_1_20" class="gfield gsection field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_20"><h2 class="gsection_title"></h2></li><li id="field_1_14" class="gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_14"><label class='gfield_label gfield_label_before_complex' >Are you of Hispanic/Latino/Spanish origin?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_1_14'><li class='gchoice gchoice_1_14_1'> <input class='gfield-choice-input' name='input_14.1' type='checkbox' value='Yes' id='choice_1_14_1' /> <label for='choice_1_14_1' id='label_1_14_1'>Yes</label> </li><li class='gchoice gchoice_1_14_2'> <input class='gfield-choice-input' name='input_14.2' type='checkbox' value='No' id='choice_1_14_2' /> <label for='choice_1_14_2' id='label_1_14_2'>No</label> </li></ul></div></li><li id="field_1_15" class="gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_15"><label class='gfield_label gfield_label_before_complex' >How would you best describe yourself?</label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_1_15'><li class='gchoice gchoice_1_15_1'> <input class='gfield-choice-input' name='input_15.1' type='checkbox' value='American Indian or Alaska Native' id='choice_1_15_1' /> <label for='choice_1_15_1' id='label_1_15_1'>American Indian or Alaska Native</label> </li><li class='gchoice gchoice_1_15_2'> <input class='gfield-choice-input' name='input_15.2' type='checkbox' value='Asian' id='choice_1_15_2' /> <label for='choice_1_15_2' id='label_1_15_2'>Asian</label> </li><li class='gchoice gchoice_1_15_3'> <input class='gfield-choice-input' name='input_15.3' type='checkbox' value='Black or African American' id='choice_1_15_3' /> <label for='choice_1_15_3' id='label_1_15_3'>Black or African American</label> </li><li class='gchoice gchoice_1_15_4'> <input class='gfield-choice-input' name='input_15.4' type='checkbox' value='Native Hawaiian or Other Pacific Islander' id='choice_1_15_4' /> <label for='choice_1_15_4' id='label_1_15_4'>Native Hawaiian or Other Pacific Islander</label> </li><li class='gchoice gchoice_1_15_5'> <input class='gfield-choice-input' name='input_15.5' type='checkbox' value='White' id='choice_1_15_5' /> <label for='choice_1_15_5' id='label_1_15_5'>White</label> </li><li class='gchoice gchoice_1_15_6'> <input class='gfield-choice-input' name='input_15.6' type='checkbox' value='Other' id='choice_1_15_6' /> <label for='choice_1_15_6' id='label_1_15_6'>Other</label> </li></ul></div></li><li id="field_1_21" class="gfield gsection field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_21"><h2 class="gsection_title"></h2></li><li id="field_1_18" class="gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_18"><label class='gfield_label gfield_label_before_complex' >Terms &amp; Conditions<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_consent'><input name='input_18.1' id='input_1_18_1' type='checkbox' value='1' aria-describedby="gfield_consent_description_1_18 gfield_description_1_18" aria-required="true" aria-invalid="false" /> <label class="gfield_consent_label" for='input_1_18_1' >I understand and acknowledge that by checking the box below, I am 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All copyrights, trademarks, content, business methods, graphics, designs and documents posted on this website, as well as the look and feel of this website ("Intellectual Property") are the property of the Hope and Healing Center & Institute.<br /> <br /> The user may download one copy of the materials on any single computer and print a copy of the materials solely for use in learning about or utilizing Gateway to Hope's training materials and resources. The user may not otherwise copy, print, reproduce, distribute, transmit, upload, download, store, use, or change the materials. All such materials are copyrighted by the Hope and Healing Center & Institute.</div></li><li id="field_1_13" class="gfield gsection field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_13"><h2 class="gsection_title"></h2></li><li id="field_1_9" class="gfield field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_1_9"><label class='gfield_label gfield_label_before_complex' >Newsletter Optin</label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_1_9'><li class='gchoice gchoice_1_9_1'> <input class='gfield-choice-input' name='input_9.1' type='checkbox' value='Please sign me up for updates, insights, resources, and more.' checked='checked' id='choice_1_9_1' /> <label for='choice_1_9_1' id='label_1_9_1'>Please sign me up for updates, insights, resources, and more.</label> </li></ul></div></li><li id="field_1_22" class="gfield gform_validation_container field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_22"><label class='gfield_label' for='input_1_22' >Email</label><div class='ginput_container'><input name='input_22' id='input_1_22' type='text' value='' autocomplete='new-password'/></div><div class='gfield_description' id='gfield_description_1_22'>This field is for validation purposes and should be left unchanged.</div></li></ul></div> <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_1' class='gform_button button' value='Submit' onclick='if(window["gf_submitting_1"]){return false;} if( !jQuery("#gform_1")[0].checkValidity || jQuery("#gform_1")[0].checkValidity()){window["gf_submitting_1"]=true;} ' onkeypress='if( event.keyCode == 13 ){ if(window["gf_submitting_1"]){return false;} if( !jQuery("#gform_1")[0].checkValidity || jQuery("#gform_1")[0].checkValidity()){window["gf_submitting_1"]=true;} jQuery("#gform_1").trigger("submit",[true]); }' /> <input type='hidden' class='gform_hidden' name='is_submit_1' value='1' /> <input type='hidden' class='gform_hidden' name='gform_submit' value='1' /> <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' /> <input type='hidden' class='gform_hidden' name='state_1' value='WyJ7XCIxOC4xXCI6XCI4ZWVjNjNkZDZhMDFjYjE5MjEyMzliY2M5YWNkNmNlMVwiLFwiMTguMlwiOlwiOTA2YWZlM2IyN2U5ZDFjYTQ4NmFkOGM4YmE3YWZlMzlcIixcIjE4LjNcIjpcImY4MGQwNTNlMzUwZjU5ZDM3M2M2YzJlZTc5ODViMzY2XCJ9IiwiZjI0MDg4NjhmY2IxNWYxMTZhN2QxYmJjNTk4YzAwNWYiXQ==' /> <input type='hidden' class='gform_hidden' name='gform_target_page_number_1' id='gform_target_page_number_1' value='0' /> <input type='hidden' class='gform_hidden' name='gform_source_page_number_1' id='gform_source_page_number_1' value='1' /> <input type='hidden' name='gform_field_values' value='' /> </div> <input type="hidden" id="ct_checkjs_28f0b864598a1291557bed248a998d4e" name="ct_checkjs" value="0" /><script type="text/javascript" >setTimeout(function(){var ct_input_name = "ct_checkjs_28f0b864598a1291557bed248a998d4e";if (document.getElementById(ct_input_name) !== null) {var ct_input_value = document.getElementById(ct_input_name).value;document.getElementById(ct_input_name).value = document.getElementById(ct_input_name).value.replace(ct_input_value, 'daff13625f026def51775140059231ba46d5adca1056f439641605167e8402c2');}}, 1000);</script></form> </div>