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--wpforms-button-size-font-size: 17px;
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			</style><div class="wpforms-container wpforms-container-full wpforms-render-modern" id="wpforms-17631"><form id="wpforms-form-17631" class="wpforms-validate wpforms-form wpforms-ajax-form" data-formid="17631" method="post" enctype="multipart/form-data" action="/organization-submission/?wpforms_form_id=17631" data-token="9fb91456dcb33917ebae6f0b30de0535" data-token-time="1781559700"><noscript class="wpforms-error-noscript">Please enable JavaScript in your browser to complete this form.</noscript><div id="wpforms-error-noscript" style="display: none;">Please enable JavaScript in your browser to complete this form.</div><div class="wpforms-field-container"><div id="wpforms-17631-field_51-container" class="wpforms-field wpforms-field-text" data-field-id="51"><label class="wpforms-field-label" for="wpforms-17631-field_51">Organization Name <span class="wpforms-required-label" aria-hidden="true">*</span></label><input type="text" id="wpforms-17631-field_51" class="wpforms-field-large wpforms-field-required" name="wpforms[fields][51]" aria-errormessage="wpforms-17631-field_51-error" required></div><div id="wpforms-17631-field_52-container" class="wpforms-field wpforms-field-textarea" data-field-id="52"><label class="wpforms-field-label" for="wpforms-17631-field_52">Organization Overview <span class="wpforms-required-label" aria-hidden="true">*</span></label><textarea id="wpforms-17631-field_52" class="wpforms-field-medium wpforms-field-required" name="wpforms[fields][52]" aria-errormessage="wpforms-17631-field_52-error" required></textarea></div><div id="wpforms-17631-field_53-container" class="wpforms-field wpforms-field-file-upload" data-field-id="53"><label class="wpforms-field-label" for="wpforms-17631-field_53">Organization Logo <span class="wpforms-required-label" aria-hidden="true">*</span></label><div
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<div id="wpforms-17631-field_53-description" class="wpforms-field-description">Upload your logo as a JPG, PNG, or SVG file.</div></div><div id="wpforms-17631-field_55-container" class="wpforms-field wpforms-field-name" data-field-id="55"><fieldset><legend class="wpforms-field-label">Contact Name <span class="wpforms-required-label" aria-hidden="true">*</span></legend><div class="wpforms-field-row wpforms-field-large"><div class="wpforms-field-row-block wpforms-first wpforms-one-half"><input type="text" id="wpforms-17631-field_55" class="wpforms-field-name-first wpforms-field-required" name="wpforms[fields][55][first]" aria-errormessage="wpforms-17631-field_55-error" required><label for="wpforms-17631-field_55" class="wpforms-field-sublabel after">First</label></div><div class="wpforms-field-row-block wpforms-one-half"><input type="text" id="wpforms-17631-field_55-last" class="wpforms-field-name-last wpforms-field-required" name="wpforms[fields][55][last]" aria-errormessage="wpforms-17631-field_55-last-error" required><label for="wpforms-17631-field_55-last" class="wpforms-field-sublabel after">Last</label></div></div></fieldset></div><div id="wpforms-17631-field_56-container" class="wpforms-field wpforms-field-email" data-field-id="56"><label class="wpforms-field-label" for="wpforms-17631-field_56">Email Address <span class="wpforms-required-label" aria-hidden="true">*</span></label><input type="email" id="wpforms-17631-field_56" class="wpforms-field-large wpforms-field-required" name="wpforms[fields][56]" spellcheck="false" aria-errormessage="wpforms-17631-field_56-error" required></div><div id="wpforms-17631-field_57-container" class="wpforms-field wpforms-field-phone" data-field-id="57"><label class="wpforms-field-label" for="wpforms-17631-field_57">Phone Number <span class="wpforms-required-label" aria-hidden="true">*</span></label><input type="tel" id="wpforms-17631-field_57" class="wpforms-field-large wpforms-field-required wpforms-smart-phone-field" data-rule-smart-phone-field="true" name="wpforms[fields][57]" aria-label="Phone Number" aria-errormessage="wpforms-17631-field_57-error" required></div><div id="wpforms-17631-field_59-container" class="wpforms-field wpforms-field-divider" data-field-id="59"><h3 id="wpforms-17631-field_59" aria-errormessage="wpforms-17631-field_59-error">Organization Location</h3></div><div id="wpforms-17631-field_60-container" class="wpforms-field wpforms-field-text wpforms-conditional-trigger" data-field-id="60"><label class="wpforms-field-label" for="wpforms-17631-field_60">Street Address <span class="wpforms-required-label" aria-hidden="true">*</span></label><input type="text" id="wpforms-17631-field_60" class="wpforms-field-large wpforms-field-required" name="wpforms[fields][60]" aria-errormessage="wpforms-17631-field_60-error" aria-describedby="wpforms-17631-field_60-description" required><div id="wpforms-17631-field_60-description" class="wpforms-field-description">Address Line 1</div></div><div id="wpforms-17631-field_61-container" class="wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show" data-field-id="61" style="display:none;"><label class="wpforms-field-label" for="wpforms-17631-field_61">Apt, Suite, Etc. (optional)</label><input type="text" id="wpforms-17631-field_61" class="wpforms-field-large" name="wpforms[fields][61]" aria-errormessage="wpforms-17631-field_61-error" aria-describedby="wpforms-17631-field_61-description" ><div id="wpforms-17631-field_61-description" class="wpforms-field-description">Address Line 2</div></div><div id="wpforms-17631-field_62-container" class="wpforms-field wpforms-field-layout" data-field-id="62"><div class="wpforms-field-layout-rows wpforms-field-large"><div class="wpforms-layout-row"><div class="wpforms-layout-column wpforms-layout-column-50"><div id="wpforms-17631-field_63-container" class="wpforms-field wpforms-field-text" data-field-id="63"><label class="wpforms-field-label" for="wpforms-17631-field_63">City <span class="wpforms-required-label" aria-hidden="true">*</span></label><input type="text" id="wpforms-17631-field_63" class="wpforms-field-medium wpforms-field-required" name="wpforms[fields][63]" placeholder="Columbia City" aria-errormessage="wpforms-17631-field_63-error" required></div></div><div class="wpforms-layout-column wpforms-layout-column-50"><div id="wpforms-17631-field_64-container" class="wpforms-field wpforms-field-select wpforms-field-select-style-classic" data-field-id="64"><label class="wpforms-field-label" for="wpforms-17631-field_64">State <span class="wpforms-required-label" aria-hidden="true">*</span></label><select id="wpforms-17631-field_64" class="wpforms-field-medium wpforms-field-required" name="wpforms[fields][64]" required="required"><option value="Indiana"  selected='selected' class="choice-14 depth-1"  >Indiana</option></select></div></div></div><div class="wpforms-layout-row"><div class="wpforms-layout-column wpforms-layout-column-50"><div id="wpforms-17631-field_65-container" class="wpforms-field wpforms-field-text" data-field-id="65"><label class="wpforms-field-label" for="wpforms-17631-field_65">Zip Code <span class="wpforms-required-label" aria-hidden="true">*</span></label><input type="text" id="wpforms-17631-field_65" class="wpforms-field-medium wpforms-field-required wpforms-masked-input" data-rule-inputmask-incomplete="1" data-inputmask-mask="99999" name="wpforms[fields][65]" value="46725" aria-errormessage="wpforms-17631-field_65-error" required></div></div><div class="wpforms-layout-column wpforms-layout-column-50"></div></div></div></div></div><!-- .wpforms-field-container --><div class="wpforms-recaptcha-container wpforms-is-recaptcha wpforms-is-recaptcha-type-v3" ><input type="hidden" name="wpforms[recaptcha]" value=""></div><div class="wpforms-submit-container" ><input type="hidden" name="wpforms[id]" value="17631"><input type="hidden" name="page_title" value="Organization Submission"><input type="hidden" name="page_url" value="https://www.columbiacityconnect.com/organization-submission/"><input type="hidden" name="url_referer" value=""><input type="hidden" name="page_id" value="17696"><input type="hidden" name="wpforms[post_id]" value="17696"><button type="submit" name="wpforms[submit]" id="wpforms-submit-17631" class="wpforms-submit button-link" data-alt-text="Sending..." data-submit-text="Submit Information" aria-live="assertive" value="wpforms-submit">Submit Information</button><img src="https://www.columbiacityconnect.com/wp-content/plugins/wpforms/assets/images/submit-spin.svg" class="wpforms-submit-spinner" style="display: none;" width="26" height="26" alt="Loading"></div></form></div>  <!-- .wpforms-container -->			</div>
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