{"id":17886,"date":"2025-10-29T23:21:38","date_gmt":"2025-10-29T22:21:38","guid":{"rendered":"https:\/\/houseofhelp.org\/?page_id=17886"},"modified":"2025-11-01T21:51:20","modified_gmt":"2025-11-01T20:51:20","slug":"care-form","status":"publish","type":"page","link":"https:\/\/houseofhelp.org\/nl\/care-form\/","title":{"rendered":"Care Form"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"17886\" class=\"elementor elementor-17886\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"has_eae_slider elementor-element elementor-element-b99fb9c e-flex e-con-boxed e-con e-parent\" data-eae-slider=\"82759\" data-id=\"b99fb9c\" data-element_type=\"container\" data-e-type=\"container\">\t\t\t<div class=\"e-con-inner\">\r\n\t\t\t\t<div class=\"elementor-element elementor-element-e41fddd elementor-widget elementor-widget-heading\" data-id=\"e41fddd\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">How can we Help? <\/h2>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\r\n\t\t\t\t<\/div>\r\n\t\t<div class=\"has_eae_slider elementor-element elementor-element-0c3ce66 e-flex e-con-boxed e-con e-parent\" data-eae-slider=\"22261\" data-id=\"0c3ce66\" data-element_type=\"container\" data-e-type=\"container\">\t\t\t<div class=\"e-con-inner\">\r\n\t\t\t\t<div class=\"elementor-element elementor-element-38f56d9 pxl-gradient elementor-widget elementor-widget-pxl_contact_form\" data-id=\"38f56d9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"pxl_contact_form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t    <div class=\"pxl-contact-form pxl-contact-form1 btn-w-auto\" data-wow-delay=\"ms\">\r\n        \n<div class=\"wpcf7 no-js\" id=\"wpcf7-f17885-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"17885\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/nl\/wp-json\/wp\/v2\/pages\/17886#wpcf7-f17885-o1\" method=\"post\" class=\"wpcf7-form init cf7mls-no-scroll cf7mls-auto-return-first-step cf7mls-no-moving-animation\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\" data-trp-original-action=\"\/nl\/wp-json\/wp\/v2\/pages\/17886#wpcf7-f17885-o1\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"17885\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.2\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f17885-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_uacf7_hidden_conditional_fields\" value=\"\" \/>\n<\/fieldset>\n<div class=\"uacf7-form-wrapper-container uacf7-form-17885\"><div class=\"wrap-ctf-page wrap-form\">\n    <div class=\"container\">\n        <div class=\"row\">\n            <div class=\"input-filled col-xl-6 col-lg-6 col-md-6 col-sm-6 col-xs-12\">\n                <span class=\"wpcf7-form-control-wrap your-name\">\n                    <span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"*Full Name\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span>\n                <\/span>\n            <\/div>   \n            <div class=\"input-filled col-xl-6 col-lg-6 col-md-6 col-sm-6 col-xs-12\">\n                <span class=\"wpcf7-form-control-wrap your-email\">\n                    <span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"*Email Address\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span>\n                <\/span>\n            <\/div> \t\n            <div class=\"input-filled col-xl-6 col-lg-6 col-md-12 col-sm-12 col-xs-12\">\n                <span class=\"wpcf7-form-control-wrap tel-835\">\n                    <span class=\"wpcf7-form-control-wrap\" data-name=\"tel-835\"><input size=\"40\" maxlength=\"15\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"*Telephone Number\" value=\"\" type=\"tel\" name=\"tel-835\" \/><\/span>\n                <\/span>\n            <\/div>\n            <div class=\"input-filled col-xl-6 col-lg-6 col-md-12 col-sm-12 col-xs-12\">\n                <span class=\"wpcf7-form-control-wrap select-249\">\n                   <span class=\"wpcf7-form-control-wrap\" data-name=\"select-249\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"select-249\"><option value=\"*Gender?\">*Gender?<\/option><option value=\"Male\">Male<\/option><option value=\"Female\">Female<\/option><\/select><\/span>\n                    \n                <\/span>\n            <\/div>\n            <div class=\"input-filled col-xl-6 col-lg-6 col-md-12 col-sm-12 col-xs-12\">\n                <span class=\"wpcf7-form-control-wrap select-43\">\n                    <span class=\"wpcf7-form-control-wrap\" data-name=\"select-43\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"select-43\"><option value=\"*What are your needs?\">*What are your needs?<\/option><option value=\"Foodstuffs- Staple foods\">Foodstuffs- Staple foods<\/option><option value=\"Foodstuffs- Infant\/Child Nutrition Products\">Foodstuffs- Infant\/Child Nutrition Products<\/option><option value=\"Clothing- Seasonal Clothing\">Clothing- Seasonal Clothing<\/option><option value=\"Clothing- Basic Clothing\">Clothing- Basic Clothing<\/option><option value=\"Other Basic Necessities\">Other Basic Necessities<\/option><\/select><\/span>\n                  \n                <\/span>\n            <\/div>  \n            <div class=\"input-filled col-xl-12\">\n                <span class=\"wpcf7-form-control-wrap your-message\">\n                     <span class=\"wpcf7-form-control-wrap\" data-name=\"text-357\"><input size=\"40\" maxlength=\"500\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" autocomplete=\"name\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"*Please share any other information that would help us care for your specific need(s)\" value=\"\" type=\"text\" name=\"text-357\" \/><\/span>\n                <\/span>\n            <\/div>\n            <div class=\"input-filled col-xl-12 d-flex\"> \n                <button type=\"submit\" class=\"wpcf7-submit wpcf7-btn-abs\">Submit<\/button>\n            <\/div>\n        <\/div>\n    <\/div>\n<\/div><\/div><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<input type=\"hidden\" name=\"trp-form-language\" value=\"nl\"\/><\/form>\n<\/div>\n    <\/div>\r\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\r\n\t\t\t\t<\/div>\r\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>How can we Help? Gender?MaleFemale What are your needs?Foodstuffs- Staple foodsFoodstuffs- Infant\/Child Nutrition ProductsClothing- Seasonal ClothingClothing- Basic ClothingOther Basic Necessities Submit<\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"give_campaign_id":0,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"class_list":["post-17886","page","type-page","status-publish","hentry"],"aioseo_notices":[],"campaignId":"","_links":{"self":[{"href":"https:\/\/houseofhelp.org\/nl\/wp-json\/wp\/v2\/pages\/17886","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/houseofhelp.org\/nl\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/houseofhelp.org\/nl\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/houseofhelp.org\/nl\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/houseofhelp.org\/nl\/wp-json\/wp\/v2\/comments?post=17886"}],"version-history":[{"count":10,"href":"https:\/\/houseofhelp.org\/nl\/wp-json\/wp\/v2\/pages\/17886\/revisions"}],"predecessor-version":[{"id":18166,"href":"https:\/\/houseofhelp.org\/nl\/wp-json\/wp\/v2\/pages\/17886\/revisions\/18166"}],"wp:attachment":[{"href":"https:\/\/houseofhelp.org\/nl\/wp-json\/wp\/v2\/media?parent=17886"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}