{"id":15733,"date":"2018-07-17T13:02:29","date_gmt":"2018-07-17T13:02:29","guid":{"rendered":"https:\/\/dukesafety.com\/firstresponders\/?page_id=15733"},"modified":"2026-08-04T19:14:05","modified_gmt":"2026-08-04T19:14:05","slug":"materials-order-form","status":"publish","type":"page","link":"https:\/\/safety.duke-energy.com\/firstresponders\/materials-order-form\/","title":{"rendered":"Materials Order Form"},"content":{"rendered":"<p><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling hide\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_4 1_4 fusion-one-fourth fusion-column-first\" style=\"--awb-bg-size:cover;width:25%;width:calc(25% - ( ( 4% ) * 0.25 ) );margin-right: 4%;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-1\"><p><img decoding=\"async\" class=\"wp-image-13985 size-200 aligncenter\" style=\"padding-top: 20px;\" src=\"https:\/\/safety.duke-energy.com\/firstresponders\/wp-content\/uploads\/2018\/02\/811-before-you-dig-tagline-with-full-color-811-logo_Vertical-01-200x196.jpg\" alt=\"Call 811 before you dig\" width=\"200\" height=\"196\" srcset=\"https:\/\/safety.duke-energy.com\/firstresponders\/wp-content\/uploads\/2018\/02\/811-before-you-dig-tagline-with-full-color-811-logo_Vertical-01-66x66.jpg 66w, https:\/\/safety.duke-energy.com\/firstresponders\/wp-content\/uploads\/2018\/02\/811-before-you-dig-tagline-with-full-color-811-logo_Vertical-01-200x196.jpg 200w, https:\/\/safety.duke-energy.com\/firstresponders\/wp-content\/uploads\/2018\/02\/811-before-you-dig-tagline-with-full-color-811-logo_Vertical-01-300x294.jpg 300w, https:\/\/safety.duke-energy.com\/firstresponders\/wp-content\/uploads\/2018\/02\/811-before-you-dig-tagline-with-full-color-811-logo_Vertical-01-400x392.jpg 400w, https:\/\/safety.duke-energy.com\/firstresponders\/wp-content\/uploads\/2018\/02\/811-before-you-dig-tagline-with-full-color-811-logo_Vertical-01-600x588.jpg 600w, https:\/\/safety.duke-energy.com\/firstresponders\/wp-content\/uploads\/2018\/02\/811-before-you-dig-tagline-with-full-color-811-logo_Vertical-01-768x753.jpg 768w, https:\/\/safety.duke-energy.com\/firstresponders\/wp-content\/uploads\/2018\/02\/811-before-you-dig-tagline-with-full-color-811-logo_Vertical-01-800x784.jpg 800w, https:\/\/safety.duke-energy.com\/firstresponders\/wp-content\/uploads\/2018\/02\/811-before-you-dig-tagline-with-full-color-811-logo_Vertical-01-1024x1003.jpg 1024w, https:\/\/safety.duke-energy.com\/firstresponders\/wp-content\/uploads\/2018\/02\/811-before-you-dig-tagline-with-full-color-811-logo_Vertical-01-1200x1176.jpg 1200w\" sizes=\"(max-width: 200px) 100vw, 200px\" \/><\/p>\n<h3 style=\"text-align: center;\">Duke Energy Indiana: 800.343.3525<br \/>\nDuke Energy Carolinas: 800.827.5118<br \/>\nDuke Energy Progress: 800.365.9947<br \/>\nDuke Energy Florida: 866.570.5949<br \/>\nDuke Energy Kentucky\/Ohio: 800.310.6346<\/h3>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_3_4 3_4 fusion-three-fourth fusion-column-last\" style=\"--awb-bg-size:cover;width:75%;width:calc(75% - ( ( 4% ) * 0.75 ) );\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-2\"><h1 class=\"fusion-responsive-typography-calculated\" data-fontsize=\"30\" data-lineheight=\"33.9px\">Order FREE Safety Training Materials<\/h1>\n<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_12' style='display:none'>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_12'  action='\/firstresponders\/wp-json\/wp\/v2\/pages\/15733' data-formid='12' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_12' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_12_59\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_59'><span class='gform-field-label__text'>URL<\/span><\/label><div class='ginput_container'><input name='input_59' id='input_12_59' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_12_59'>This field is for validation purposes and should be left unchanged.<\/div><\/div><div id=\"field_12_58\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style=\"padding:10px;  margin-top:30px; background-color: #005984;\">\n<p style=\"color: #fff; size:20px; margin: 0 0 0 5px;\"><strong>How many kits do you require?<\/strong><\/p><\/div><\/div><div id=\"field_12_56\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_56'><span class='gform-field-label__text'>How many kits do you require?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_12_56'>(Please refer to the previous page to see what is included in each kit.)<\/div><div class='ginput_container ginput_container_select'><select name='input_56' id='input_12_56' class='medium gfield_select'  aria-describedby=\"gfield_description_12_56\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='1' selected='selected'>1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><\/select><\/div><\/div><div id=\"field_12_57\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style=\"padding:10px;  margin-top:30px; background-color: #005984;\">\n<p style=\"color: #fff; size:20px; margin: 0 0 0 5px;\"><strong>Where should we mail your FREE safety materials?<\/strong><\/p><\/div><\/div><div id=\"field_12_44\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_44'><span class='gform-field-label__text'>First Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_44' id='input_12_44' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_45\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_45'><span class='gform-field-label__text'>Last Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_45' id='input_12_45' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_4\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_4'><span class='gform-field-label__text'>Title<\/span><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_12_4' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_5\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_5'><span class='gform-field-label__text'>Organization<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_12_5' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_36\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_36'><span class='gform-field-label__text'>Address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_36' id='input_12_36' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_37\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_37'><span class='gform-field-label__text'>City<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_37' id='input_12_37' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_12_6\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Check if this is a home address.<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_12_6'><div class='gchoice gchoice_12_6_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_6.1' type='checkbox'  value='This is a home address.'  id='choice_12_6_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_6_1' id='label_12_6_1' class='gform-field-label gform-field-label--type-inline'>This is a home address.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_12_54\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_54'><span class='gform-field-label__text'>State<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_54' id='input_12_54' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' >-- Select a state --<\/option><option value='FL' >Florida<\/option><option value='IN' >Indiana<\/option><option value='KY' >Kentucky<\/option><option value='NC' >North Carolina<\/option><option value='OH' >Ohio<\/option><option value='SC' >South Carolina<\/option><\/select><\/div><\/div><div id=\"field_12_41\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_41'><span class='gform-field-label__text'>Zip Code<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_41' id='input_12_41' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_8\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_8'><span class='gform-field-label__text'>Phone<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_8' id='input_12_8' type='tel' value='' class='large'  placeholder='(999) 999-9999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/div><div id=\"field_12_9\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_9'><span class='gform-field-label__text'>Email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_9' id='input_12_9' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_12_10\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_3col field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-columns\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>How many employees in your organization:<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_10'>\n\t\t\t<div class='gchoice gchoice_12_10_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='0-5'  id='choice_12_10_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_10_0' id='label_12_10_0' class='gform-field-label gform-field-label--type-inline'>0-5<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_10_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='6-10'  id='choice_12_10_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_10_1' id='label_12_10_1' class='gform-field-label gform-field-label--type-inline'>6-10<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_10_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='11-20'  id='choice_12_10_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_10_2' id='label_12_10_2' class='gform-field-label gform-field-label--type-inline'>11-20<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_10_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='21-50'  id='choice_12_10_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_10_3' id='label_12_10_3' class='gform-field-label gform-field-label--type-inline'>21-50<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_10_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='51+'  id='choice_12_10_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_10_4' id='label_12_10_4' class='gform-field-label gform-field-label--type-inline'>51+<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_10_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='NA'  id='choice_12_10_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_10_5' id='label_12_10_5' class='gform-field-label gform-field-label--type-inline'>NA<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_11\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gf_list_4col field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-columns\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>What is the nature of your organization? (Check all that apply)<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_12_11'><div class='gchoice gchoice_12_11_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.1' type='checkbox'  value='Police'  id='choice_12_11_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_1' id='label_12_11_1' class='gform-field-label gform-field-label--type-inline'>Police<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_11_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.2' type='checkbox'  value='Fire'  id='choice_12_11_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_2' id='label_12_11_2' class='gform-field-label gform-field-label--type-inline'>Fire<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_11_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.3' type='checkbox'  value='EMS'  id='choice_12_11_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_3' id='label_12_11_3' class='gform-field-label gform-field-label--type-inline'>EMS<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_11_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.4' type='checkbox'  value='Search\/Rescue'  id='choice_12_11_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_4' id='label_12_11_4' class='gform-field-label gform-field-label--type-inline'>Search\/Rescue<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_11_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.5' type='checkbox'  value='Sheriff'  id='choice_12_11_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_5' id='label_12_11_5' class='gform-field-label gform-field-label--type-inline'>Sheriff<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_11_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.6' type='checkbox'  value='Volunteer Fire'  id='choice_12_11_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_6' id='label_12_11_6' class='gform-field-label gform-field-label--type-inline'>Volunteer Fire<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_11_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.7' type='checkbox'  value='Combined Fire\/EMS'  id='choice_12_11_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_7' id='label_12_11_7' class='gform-field-label gform-field-label--type-inline'>Combined Fire\/EMS<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_11_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.8' type='checkbox'  value='Highway Patrol'  id='choice_12_11_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_8' id='label_12_11_8' class='gform-field-label gform-field-label--type-inline'>Highway Patrol<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_11_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.9' type='checkbox'  value='Other'  id='choice_12_11_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_9' id='label_12_11_9' class='gform-field-label gform-field-label--type-inline'>Other (please explain)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_12_12\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_12'><span class='gform-field-label__text'>Other organization (please explain)<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_12_12' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_12_42\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>How will you use these safety materials? (check all that apply)<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_12_42'><div class='gchoice gchoice_12_42_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.1' type='checkbox'  value='Safety meeting\/training'  id='choice_12_42_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_42_1' id='label_12_42_1' class='gform-field-label gform-field-label--type-inline'>Safety meeting\/training<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_42_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.2' type='checkbox'  value='New Recruit'  id='choice_12_42_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_42_2' id='label_12_42_2' class='gform-field-label gform-field-label--type-inline'>New Recruit<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_42_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.3' type='checkbox'  value='Other'  id='choice_12_42_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_42_3' id='label_12_42_3' class='gform-field-label gform-field-label--type-inline'>Other (please explain)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_12_43\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_43'><span class='gform-field-label__text'>Other uses (please explain)<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_43' id='input_12_43' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_13\" class=\"gfield gfield--type-textarea gfield--input-type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_13'><span class='gform-field-label__text'>What do you feel are the most important safety topics that need to be covered in training materials?<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_13' id='input_12_13' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_12_22\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style=\"padding:10px;  margin-top:30px; background-color: #005984;\">\n<p style=\"color: #fff; size:20px; margin: 0 0 0 5px;\"><strong>How much do you agree with each of the following statements?<\/strong><\/p><\/div><\/div><div id=\"field_12_30\" class=\"gfield gfield--type-survey gfield--input-type-likert field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Duke Energy is committed to the safety of first responders like me.<\/span><\/label><div class='ginput_container ginput_container_likert'><table aria-label='Duke Energy is committed to the safety of first responders like me.' class='gsurvey-likert' id='input_12_30'><thead><tr><th id='likert_col_1_12_30' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Strongly agree<\/th><th id='likert_col_2_12_30' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Agree<\/th><th id='likert_col_3_12_30' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Neutral<\/th><th id='likert_col_4_12_30' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Disagree<\/th><th id='likert_col_5_12_30' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Strongly disagree<\/th><\/tr><\/thead><tbody><tr><td data-label='Strongly agree' class='gsurvey-likert-choice'><input name='input_30' type='radio' value='glikertcol293e3084bc'  id='choice_12_30_1'    aria-labelledby='likert_col_1_12_30'\/><\/td><td data-label='Agree' class='gsurvey-likert-choice'><input name='input_30' type='radio' value='glikertcol296c83a295'  id='choice_12_30_2'    aria-labelledby='likert_col_2_12_30'\/><\/td><td data-label='Neutral' class='gsurvey-likert-choice'><input name='input_30' type='radio' value='glikertcol29055a5493'  id='choice_12_30_3'    aria-labelledby='likert_col_3_12_30'\/><\/td><td data-label='Disagree' class='gsurvey-likert-choice'><input name='input_30' type='radio' value='glikertcol29a7ecaa79'  id='choice_12_30_4'    aria-labelledby='likert_col_4_12_30'\/><\/td><td data-label='Strongly disagree' class='gsurvey-likert-choice'><input name='input_30' type='radio' value='glikertcol296a56f36a'  id='choice_12_30_5'    aria-labelledby='likert_col_5_12_30'\/><\/td><\/tr><\/tbody><\/table><\/div><\/div><div id=\"field_12_31\" class=\"gfield gfield--type-survey gfield--input-type-likert field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>The information Duke Energy provides is valuable for keeping first responders safe around electricity.<\/span><\/label><div class='ginput_container ginput_container_likert'><table aria-label='The information Duke Energy provides is valuable for keeping first responders safe around electricity.' class='gsurvey-likert' id='input_12_31'><thead><tr><th id='likert_col_1_12_31' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Strongly agree<\/th><th id='likert_col_2_12_31' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Agree<\/th><th id='likert_col_3_12_31' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Neutral<\/th><th id='likert_col_4_12_31' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Disagree<\/th><th id='likert_col_5_12_31' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Strongly disagree<\/th><\/tr><\/thead><tbody><tr><td data-label='Strongly agree' class='gsurvey-likert-choice'><input name='input_31' type='radio' value='glikertcol293e3084bc'  id='choice_12_31_1'    aria-labelledby='likert_col_1_12_31'\/><\/td><td data-label='Agree' class='gsurvey-likert-choice'><input name='input_31' type='radio' value='glikertcol296c83a295'  id='choice_12_31_2'    aria-labelledby='likert_col_2_12_31'\/><\/td><td data-label='Neutral' class='gsurvey-likert-choice'><input name='input_31' type='radio' value='glikertcol29055a5493'  id='choice_12_31_3'    aria-labelledby='likert_col_3_12_31'\/><\/td><td data-label='Disagree' class='gsurvey-likert-choice'><input name='input_31' type='radio' value='glikertcol29a7ecaa79'  id='choice_12_31_4'    aria-labelledby='likert_col_4_12_31'\/><\/td><td data-label='Strongly disagree' class='gsurvey-likert-choice'><input name='input_31' type='radio' value='glikertcol296a56f36a'  id='choice_12_31_5'    aria-labelledby='likert_col_5_12_31'\/><\/td><\/tr><\/tbody><\/table><\/div><\/div><div id=\"field_12_33\" class=\"gfield gfield--type-survey gfield--input-type-likert field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>I expect Duke Energy to provide first responders the information necessary to get their jobs done safely around Duke Energy&#039;s electric infrastructure.<\/span><\/label><div class='ginput_container ginput_container_likert'><table aria-label='I expect Duke Energy to provide first responders the information necessary to get their jobs done safely around Duke Energy&#039;s electric infrastructure.' class='gsurvey-likert' id='input_12_33'><thead><tr><th id='likert_col_1_12_33' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Strongly agree<\/th><th id='likert_col_2_12_33' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Agree<\/th><th id='likert_col_3_12_33' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Neutral<\/th><th id='likert_col_4_12_33' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Disagree<\/th><th id='likert_col_5_12_33' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Strongly disagree<\/th><\/tr><\/thead><tbody><tr><td data-label='Strongly agree' class='gsurvey-likert-choice'><input name='input_33' type='radio' value='glikertcol293e3084bc'  id='choice_12_33_1'    aria-labelledby='likert_col_1_12_33'\/><\/td><td data-label='Agree' class='gsurvey-likert-choice'><input name='input_33' type='radio' value='glikertcol296c83a295'  id='choice_12_33_2'    aria-labelledby='likert_col_2_12_33'\/><\/td><td data-label='Neutral' class='gsurvey-likert-choice'><input name='input_33' type='radio' value='glikertcol29055a5493'  id='choice_12_33_3'    aria-labelledby='likert_col_3_12_33'\/><\/td><td data-label='Disagree' class='gsurvey-likert-choice'><input name='input_33' type='radio' value='glikertcol29a7ecaa79'  id='choice_12_33_4'    aria-labelledby='likert_col_4_12_33'\/><\/td><td data-label='Strongly disagree' class='gsurvey-likert-choice'><input name='input_33' type='radio' value='glikertcol296a56f36a'  id='choice_12_33_5'    aria-labelledby='likert_col_5_12_33'\/><\/td><\/tr><\/tbody><\/table><\/div><\/div><div id=\"field_12_34\" class=\"gfield gfield--type-survey gfield--input-type-likert field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>The first responders at my organization use Duke Energy safety information to work more safely around electricity.<\/span><\/label><div class='ginput_container ginput_container_likert'><table aria-label='The first responders at my organization use Duke Energy safety information to work more safely around electricity.' class='gsurvey-likert' id='input_12_34'><thead><tr><th id='likert_col_1_12_34' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Strongly agree<\/th><th id='likert_col_2_12_34' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Agree<\/th><th id='likert_col_3_12_34' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Neutral<\/th><th id='likert_col_4_12_34' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Disagree<\/th><th id='likert_col_5_12_34' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Strongly disagree<\/th><\/tr><\/thead><tbody><tr><td data-label='Strongly agree' class='gsurvey-likert-choice'><input name='input_34' type='radio' value='glikertcol293e3084bc'  id='choice_12_34_1'    aria-labelledby='likert_col_1_12_34'\/><\/td><td data-label='Agree' class='gsurvey-likert-choice'><input name='input_34' type='radio' value='glikertcol296c83a295'  id='choice_12_34_2'    aria-labelledby='likert_col_2_12_34'\/><\/td><td data-label='Neutral' class='gsurvey-likert-choice'><input name='input_34' type='radio' value='glikertcol29055a5493'  id='choice_12_34_3'    aria-labelledby='likert_col_3_12_34'\/><\/td><td data-label='Disagree' class='gsurvey-likert-choice'><input name='input_34' type='radio' value='glikertcol29a7ecaa79'  id='choice_12_34_4'    aria-labelledby='likert_col_4_12_34'\/><\/td><td data-label='Strongly disagree' class='gsurvey-likert-choice'><input name='input_34' type='radio' value='glikertcol296a56f36a'  id='choice_12_34_5'    aria-labelledby='likert_col_5_12_34'\/><\/td><\/tr><\/tbody><\/table><\/div><\/div><div id=\"field_12_35\" class=\"gfield gfield--type-survey gfield--input-type-likert field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>The first responders materials provided by Duke Energy help me and\/or my coworkers perform our jobs more safely.<\/span><\/label><div class='ginput_container ginput_container_likert'><table aria-label='The first responders materials provided by Duke Energy help me and\/or my coworkers perform our jobs more safely.' class='gsurvey-likert' id='input_12_35'><thead><tr><th id='likert_col_1_12_35' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Strongly agree<\/th><th id='likert_col_2_12_35' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Agree<\/th><th id='likert_col_3_12_35' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Neutral<\/th><th id='likert_col_4_12_35' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Disagree<\/th><th id='likert_col_5_12_35' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Strongly disagree<\/th><\/tr><\/thead><tbody><tr><td data-label='Strongly agree' class='gsurvey-likert-choice'><input name='input_35' type='radio' value='glikertcol293e3084bc'  id='choice_12_35_1'    aria-labelledby='likert_col_1_12_35'\/><\/td><td data-label='Agree' class='gsurvey-likert-choice'><input name='input_35' type='radio' value='glikertcol296c83a295'  id='choice_12_35_2'    aria-labelledby='likert_col_2_12_35'\/><\/td><td data-label='Neutral' class='gsurvey-likert-choice'><input name='input_35' type='radio' value='glikertcol29055a5493'  id='choice_12_35_3'    aria-labelledby='likert_col_3_12_35'\/><\/td><td data-label='Disagree' class='gsurvey-likert-choice'><input name='input_35' type='radio' value='glikertcol29a7ecaa79'  id='choice_12_35_4'    aria-labelledby='likert_col_4_12_35'\/><\/td><td data-label='Strongly disagree' class='gsurvey-likert-choice'><input name='input_35' type='radio' value='glikertcol296a56f36a'  id='choice_12_35_5'    aria-labelledby='likert_col_5_12_35'\/><\/td><\/tr><\/tbody><\/table><\/div><\/div><div id=\"field_12_26\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style=\"padding:10px; margin: 30px 0 15px 0; background-color: #ccc;\">\n<p style=\"color: #fff; size:20px; margin: 0 0 0 5px;\">Internal Use Only<\/p><\/div><\/div><div id=\"field_12_23\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third gfield_label_gray field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_23'><span class='gform-field-label__text'>ID<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_12_23' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_24\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third gfield_label_gray field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_24'><span class='gform-field-label__text'>BRC Code<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_24' id='input_12_24' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_25\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third gfield_label_gray field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_25'><span class='gform-field-label__text'>Date (mm\/dd\/yy)<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_25' id='input_12_25' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_47\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_47' id='input_12_47' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='8013' \/><\/div><\/div><fieldset id=\"field_12_48\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden gfield--choice-align-vertical\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Project Category<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_48'>\n\t\t\t<div class='gchoice gchoice_12_48_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_48' type='radio' value='school'  id='choice_12_48_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_48_0' id='label_12_48_0' class='gform-field-label gform-field-label--type-inline'>school<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_48_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_48' type='radio' value='contractor'  id='choice_12_48_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_48_1' id='label_12_48_1' class='gform-field-label gform-field-label--type-inline'>contractor<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_48_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_48' type='radio' value='first responder' checked='checked' id='choice_12_48_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_48_2' id='label_12_48_2' class='gform-field-label gform-field-label--type-inline'>first responder<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_48_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_48' type='radio' value='other'  id='choice_12_48_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_48_3' id='label_12_48_3' class='gform-field-label gform-field-label--type-inline'>other<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_12_49\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_49' id='input_12_49' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_12_50\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_50' id='input_12_50' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='0' \/><\/div><\/div><div id=\"field_12_51\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_51' id='input_12_51' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_12_52\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_52' id='input_12_52' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='https:\/\/safety.duke-energy.com\/firstresponders\/materials-order-form\/' \/><\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <button type='submit' id='gform_submit_button_12' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Order<\/button> <input type='hidden' class='gform_hidden' name='gform_submission_speeds' value='{&quot;pages&quot;:[]}' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_12' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_12' id='gform_theme_12' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_12' id='gform_style_settings_12' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_12' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='12' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='4rNOOZZFRhn4y4oSXRRnaXfr07tPpgFSqqo94Su1lFGvkGHUNKfUfwrzGgdyVwiBpWXD1oKPKmOru4iLgp0cxz+sDd1znWgUlTn5ARr+HFnCC2I=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_12' value='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' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_12' id='gform_target_page_number_12' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_12' id='gform_source_page_number_12' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2 has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_4 1_4 fusion-one-fourth fusion-column-first\" style=\"--awb-bg-size:cover;width:25%;width:calc(25% - ( ( 4% ) * 0.25 ) );margin-right: 4%;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-3\"><p><img decoding=\"async\" class=\"wp-image-13985 size-200 aligncenter\" style=\"padding-top: 20px;\" src=\"https:\/\/safety.duke-energy.com\/firstresponders\/wp-content\/uploads\/2018\/02\/811-before-you-dig-tagline-with-full-color-811-logo_Vertical-01-200x196.jpg\" alt=\"Call 811 before you dig\" width=\"200\" height=\"196\" srcset=\"https:\/\/safety.duke-energy.com\/firstresponders\/wp-content\/uploads\/2018\/02\/811-before-you-dig-tagline-with-full-color-811-logo_Vertical-01-66x66.jpg 66w, https:\/\/safety.duke-energy.com\/firstresponders\/wp-content\/uploads\/2018\/02\/811-before-you-dig-tagline-with-full-color-811-logo_Vertical-01-200x196.jpg 200w, https:\/\/safety.duke-energy.com\/firstresponders\/wp-content\/uploads\/2018\/02\/811-before-you-dig-tagline-with-full-color-811-logo_Vertical-01-300x294.jpg 300w, https:\/\/safety.duke-energy.com\/firstresponders\/wp-content\/uploads\/2018\/02\/811-before-you-dig-tagline-with-full-color-811-logo_Vertical-01-400x392.jpg 400w, https:\/\/safety.duke-energy.com\/firstresponders\/wp-content\/uploads\/2018\/02\/811-before-you-dig-tagline-with-full-color-811-logo_Vertical-01-600x588.jpg 600w, https:\/\/safety.duke-energy.com\/firstresponders\/wp-content\/uploads\/2018\/02\/811-before-you-dig-tagline-with-full-color-811-logo_Vertical-01-768x753.jpg 768w, https:\/\/safety.duke-energy.com\/firstresponders\/wp-content\/uploads\/2018\/02\/811-before-you-dig-tagline-with-full-color-811-logo_Vertical-01-800x784.jpg 800w, https:\/\/safety.duke-energy.com\/firstresponders\/wp-content\/uploads\/2018\/02\/811-before-you-dig-tagline-with-full-color-811-logo_Vertical-01-1024x1003.jpg 1024w, https:\/\/safety.duke-energy.com\/firstresponders\/wp-content\/uploads\/2018\/02\/811-before-you-dig-tagline-with-full-color-811-logo_Vertical-01-1200x1176.jpg 1200w\" sizes=\"(max-width: 200px) 100vw, 200px\" \/><\/p>\n<h3 style=\"text-align: center;\">Duke Energy Indiana: 800.343.3525<br \/>\nDuke Energy Carolinas: 800.827.5118<br \/>\nDuke Energy Progress: 800.365.9947<br \/>\nDuke Energy Florida: 866.570.5949<br \/>\nDuke Energy Kentucky\/Ohio: 800.310.6346<\/h3>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_3_4 3_4 fusion-three-fourth fusion-column-last\" style=\"--awb-bg-size:cover;width:75%;width:calc(75% - ( ( 4% ) * 0.75 ) );\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-4\"><h1>Order Free Safety Materials<\/h1>\n<p><strong>The 2026 program is now closed. Please check back in 2027 for the new program.<\/strong><\/p>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":36,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-15733","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/safety.duke-energy.com\/firstresponders\/wp-json\/wp\/v2\/pages\/15733","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/safety.duke-energy.com\/firstresponders\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/safety.duke-energy.com\/firstresponders\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/safety.duke-energy.com\/firstresponders\/wp-json\/wp\/v2\/users\/36"}],"replies":[{"embeddable":true,"href":"https:\/\/safety.duke-energy.com\/firstresponders\/wp-json\/wp\/v2\/comments?post=15733"}],"version-history":[{"count":32,"href":"https:\/\/safety.duke-energy.com\/firstresponders\/wp-json\/wp\/v2\/pages\/15733\/revisions"}],"predecessor-version":[{"id":18869,"href":"https:\/\/safety.duke-energy.com\/firstresponders\/wp-json\/wp\/v2\/pages\/15733\/revisions\/18869"}],"wp:attachment":[{"href":"https:\/\/safety.duke-energy.com\/firstresponders\/wp-json\/wp\/v2\/media?parent=15733"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}