{"id":280,"date":"2016-04-13T13:37:56","date_gmt":"2016-04-13T13:37:56","guid":{"rendered":"http:\/\/aacpm.org.php56-1.dfw3-1.websitetestlink.com\/?page_id=280"},"modified":"2016-04-13T14:08:37","modified_gmt":"2016-04-13T14:08:37","slug":"request-information","status":"publish","type":"page","link":"https:\/\/aacpm.org\/becoming-a-podiatric-physician\/request-information\/","title":{"rendered":"Request Information"},"content":{"rendered":"<section class=\"wpb-content-wrapper\"><p>[vc_row row_id=&#8221;main-content&#8221;][vc_column width=&#8221;1\/1&#8243;]<h2 class=\"headline font-inherit fontsize-inherit fontweight-inherit lh-inherit align-left transform-inherit \" style=\"margin: 0 0 20px 0;\">AACPM Request Form<\/h2><script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var 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gform-field-label' for='input_2_20'>City<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_20' id='input_2_20' type='text' value='' class='large'    placeholder='Enter City' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_21\" class=\"gfield gfield--type-select float-left gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_21\" ><label class='gfield_label gform-field-label' for='input_2_21'>State<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_21' id='input_2_21' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' 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