{"id":7059,"date":"2021-11-03T01:09:27","date_gmt":"2021-11-03T08:09:27","guid":{"rendered":"https:\/\/www.breakingcodesilence.org\/template-2-5\/"},"modified":"2022-03-14T14:17:32","modified_gmt":"2022-03-14T21:17:32","slug":"volunteer-sign-up-form","status":"publish","type":"page","link":"https:\/\/www.breakingcodesilence.org\/about-us\/volunteer\/volunteer-sign-up-form\/","title":{"rendered":"Volunteer Application Form"},"content":{"rendered":"<p><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"background-color: #ffffff;background-position: center center;background-repeat: no-repeat;border-width: 0px 0px 0px 0px;border-color:var(--awb-color8);border-style:solid;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-text fusion-text-1\" style=\"font-size:40px;font-family:&quot;Bobby Jones&quot;;font-weight:400;\"><h1 style=\"text-align: center;\"><img decoding=\"async\" class=\"lazyload wp-image-5239 alignnone\" src=\"data:image\/svg+xml,%3Csvg%20xmlns%3D%27http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg%27%20width%3D%27103%27%20height%3D%2794%27%20viewBox%3D%270%200%20103%2094%27%3E%3Crect%20width%3D%27103%27%20height%3D%2794%27%20fill-opacity%3D%220%22%2F%3E%3C%2Fsvg%3E\" data-orig-src=\"http:\/\/www.breakingcodesilence.org\/wp-content\/uploads\/2021\/10\/w-6.png\" alt=\"\" width=\"103\" height=\"94\" \/><\/h1>\n<h1 style=\"text-align: center;\">Join the TeaM<\/h1>\n<\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-builder-column-0{width:100% !important;margin-top : 0px;margin-bottom : 20px;}.fusion-builder-column-0 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 1.92%;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 1.92%;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-column-0{width:100% !important;order : 0;}.fusion-builder-column-0 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}@media only screen and (max-width:480px) {.fusion-body .fusion-builder-column-0{width:100% !important;order : 0;}.fusion-builder-column-0 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}<\/style><\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-flex-container.fusion-builder-row-1{ padding-top : 0px;margin-top : 0px;padding-right : 0px;padding-bottom : 0px;margin-bottom : 0px;padding-left : 0px;}<\/style><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"background-color: #ffffff;background-position: center center;background-repeat: no-repeat;border-width: 0px 0px 0px 0px;border-color:var(--awb-color8);border-style:solid;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_4 1_4 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><\/div><style type=\"text\/css\">.fusion-body .fusion-builder-column-1{width:25% !important;margin-top : 0px;margin-bottom : 20px;}.fusion-builder-column-1 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 7.68%;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 7.68%;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-column-1{width:100% !important;order : 0;}.fusion-builder-column-1 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}@media only screen and (max-width:480px) {.fusion-body .fusion-builder-column-1{width:100% !important;order : 0;}.fusion-builder-column-1 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}<\/style><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_2 1_2 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-text fusion-text-2\" style=\"font-family:&quot;Montserrat&quot;;font-weight:300;\"><p>&nbsp;<\/p>\n<\/div><!-- Begin Mailchimp Signup Form -->\n<link href=\"\/\/cdn-images.mailchimp.com\/embedcode\/classic-10_7.css\" rel=\"stylesheet\" type=\"text\/css\">\n<style type=\"text\/css\">\n\t#mc_embed_signup{background:#fff; clear:left; font:14px Helvetica,Arial,sans-serif; }\n\t\/* Add your own Mailchimp form style overrides in your site stylesheet or in this style block.\n\t   We recommend moving this block and the preceding CSS link to the HEAD of your HTML file. *\/\n<\/style>\n<div id=\"mc_embed_signup\">\n<form action=\"https:\/\/BreakingCodeSilence.us1.list-manage.com\/subscribe\/post?u=46e2757a585c5e5dc24a9b5ff&id=e3748666e6\" method=\"post\" id=\"mc-embedded-subscribe-form\" name=\"mc-embedded-subscribe-form\" class=\"validate\" target=\"_blank\" novalidate>\n    <div id=\"mc_embed_signup_scroll\">\n\t<h2>Sign Up to Volunteer with Breaking Code Silence!<\/h2>\n<div class=\"indicates-required\"><span class=\"asterisk\">*<\/span> indicates required<\/div>\n<div class=\"mc-field-group\">\n\t<label for=\"mce-FNAME\">First Name  <span class=\"asterisk\">*<\/span>\n<\/label>\n\t<input type=\"text\" value=\"\" name=\"FNAME\" class=\"required\" id=\"mce-FNAME\">\n<\/div>\n<div class=\"mc-field-group\">\n\t<label for=\"mce-LNAME\">Last Name  <span class=\"asterisk\">*<\/span>\n<\/label>\n\t<input type=\"text\" value=\"\" name=\"LNAME\" class=\"required\" id=\"mce-LNAME\">\n<\/div>\n<div class=\"mc-field-group\">\n\t<label for=\"mce-EMAIL\">Email Address  <span class=\"asterisk\">*<\/span>\n<\/label>\n\t<input type=\"email\" value=\"\" name=\"EMAIL\" class=\"required email\" id=\"mce-EMAIL\">\n<\/div>\n<div class=\"mc-field-group size1of2\">\n\t<label for=\"mce-PHONE\">Phone Number <\/label>\n\t<input type=\"text\" name=\"PHONE\" class=\"\" value=\"\" id=\"mce-PHONE\">\n<\/div>\n<div class=\"mc-field-group\">\n\t<label for=\"mce-SKILLS\">What skills or talents should we know about?  <span class=\"asterisk\">*<\/span>\n<\/label>\n\t<input type=\"text\" value=\"\" name=\"SKILLS\" class=\"required\" id=\"mce-SKILLS\">\n<\/div>\n<div class=\"mc-field-group\">\n\t<label for=\"mce-DEGREE\">Any degrees, certifications, prof. licensing, etc?  <span class=\"asterisk\">*<\/span>\n<\/label>\n\t<input type=\"text\" value=\"\" name=\"DEGREE\" class=\"required\" id=\"mce-DEGREE\">\n<\/div>\n<div class=\"mc-address-group\">\n\t<div class=\"mc-field-group\">\n\t    <label for=\"mce-ADDRESS-addr1\">Address <\/label>\n\t\t<input type=\"text\" value=\"\" maxlength=\"70\" name=\"ADDRESS[addr1]\" id=\"mce-ADDRESS-addr1\" class=\"\">\n\t<\/div>\n\t<div class=\"mc-field-group\">\n\t    <label for=\"mce-ADDRESS-addr2\">Address Line 2<\/label>\n\t\t<input type=\"text\" value=\"\" maxlength=\"70\" name=\"ADDRESS[addr2]\" id=\"mce-ADDRESS-addr2\">\t\t\n\t<\/div>\n\t<div class=\"mc-field-group size1of2\">\n\t    <label for=\"mce-ADDRESS-city\">City<\/label>\n\t\t<input type=\"text\" value=\"\" maxlength=\"40\" name=\"ADDRESS[city]\" id=\"mce-ADDRESS-city\" class=\"\">\n\t<\/div>\n\t<div class=\"mc-field-group size1of2\">\n\t    <label for=\"mce-ADDRESS-state\">State\/Province\/Region<\/label>\n\t<input type=\"text\" value=\"\" maxlength=\"20\" name=\"ADDRESS[state]\" id=\"mce-ADDRESS-state\" class=\"\">\n\t<\/div>\n\t<div class=\"mc-field-group size1of2\">\n\t    <label for=\"mce-ADDRESS-zip\">Postal \/ Zip Code<\/label>\n\t\t<input type=\"text\" value=\"\" maxlength=\"10\" name=\"ADDRESS[zip]\" id=\"mce-ADDRESS-zip\" class=\"\">\n\t<\/div>\n\t<div class=\"mc-field-group size1of2\">\n\t    <label for=\"mce-ADDRESS-country\">Country<\/label>\n\t\t<select name=\"ADDRESS[country]\" id=\"mce-ADDRESS-country\" class=\"\"><option value=\"164\" selected>USA<\/option><option value=\"286\">Aaland Islands<\/option><option value=\"274\">Afghanistan<\/option><option value=\"2\">Albania<\/option><option value=\"3\">Algeria<\/option><option value=\"178\">American Samoa<\/option><option value=\"4\">Andorra<\/option><option value=\"5\">Angola<\/option><option value=\"176\">Anguilla<\/option><option value=\"175\">Antigua And Barbuda<\/option><option value=\"6\">Argentina<\/option><option value=\"7\">Armenia<\/option><option value=\"179\">Aruba<\/option><option value=\"8\">Australia<\/option><option value=\"9\">Austria<\/option><option value=\"10\">Azerbaijan<\/option><option value=\"11\">Bahamas<\/option><option value=\"12\">Bahrain<\/option><option value=\"13\">Bangladesh<\/option><option value=\"14\">Barbados<\/option><option value=\"15\">Belarus<\/option><option value=\"16\">Belgium<\/option><option value=\"17\">Belize<\/option><option value=\"18\">Benin<\/option><option value=\"19\">Bermuda<\/option><option value=\"20\">Bhutan<\/option><option value=\"21\">Bolivia<\/option><option value=\"325\">Bonaire, Saint Eustatius and Saba<\/option><option value=\"22\">Bosnia and Herzegovina<\/option><option value=\"23\">Botswana<\/option><option value=\"181\">Bouvet Island<\/option><option value=\"24\">Brazil<\/option><option value=\"180\">Brunei Darussalam<\/option><option value=\"25\">Bulgaria<\/option><option value=\"26\">Burkina Faso<\/option><option value=\"27\">Burundi<\/option><option value=\"28\">Cambodia<\/option><option value=\"29\">Cameroon<\/option><option value=\"30\">Canada<\/option><option value=\"31\">Cape Verde<\/option><option value=\"32\">Cayman Islands<\/option><option value=\"33\">Central African Republic<\/option><option value=\"34\">Chad<\/option><option value=\"35\">Chile<\/option><option value=\"36\">China<\/option><option value=\"185\">Christmas Island<\/option><option value=\"37\">Colombia<\/option><option value=\"204\">Comoros<\/option><option value=\"38\">Congo<\/option><option value=\"183\">Cook Islands<\/option><option value=\"268\">Costa Rica<\/option><option value=\"275\">Cote D'Ivoire<\/option><option value=\"40\">Croatia<\/option><option value=\"276\">Cuba<\/option><option value=\"298\">Curacao<\/option><option value=\"41\">Cyprus<\/option><option value=\"42\">Czech Republic<\/option><option value=\"318\">Democratic Republic of the Congo<\/option><option value=\"43\">Denmark<\/option><option value=\"44\">Djibouti<\/option><option value=\"289\">Dominica<\/option><option value=\"187\">Dominican Republic<\/option><option value=\"45\">Ecuador<\/option><option value=\"46\">Egypt<\/option><option value=\"47\">El Salvador<\/option><option value=\"48\">Equatorial Guinea<\/option><option value=\"49\">Eritrea<\/option><option value=\"50\">Estonia<\/option><option value=\"51\">Ethiopia<\/option><option value=\"189\">Falkland Islands<\/option><option value=\"191\">Faroe Islands<\/option><option value=\"52\">Fiji<\/option><option value=\"53\">Finland<\/option><option value=\"54\">France<\/option><option value=\"193\">French Guiana<\/option><option value=\"277\">French Polynesia<\/option><option value=\"56\">Gabon<\/option><option value=\"57\">Gambia<\/option><option value=\"58\">Georgia<\/option><option value=\"59\">Germany<\/option><option value=\"60\">Ghana<\/option><option value=\"194\">Gibraltar<\/option><option value=\"61\">Greece<\/option><option value=\"195\">Greenland<\/option><option value=\"192\">Grenada<\/option><option value=\"196\">Guadeloupe<\/option><option value=\"62\">Guam<\/option><option value=\"198\">Guatemala<\/option><option value=\"270\">Guernsey<\/option><option value=\"63\">Guinea<\/option><option value=\"65\">Guyana<\/option><option value=\"200\">Haiti<\/option><option value=\"66\">Honduras<\/option><option value=\"67\">Hong Kong<\/option><option value=\"68\">Hungary<\/option><option value=\"69\">Iceland<\/option><option value=\"70\">India<\/option><option value=\"71\">Indonesia<\/option><option value=\"278\">Iran<\/option><option value=\"279\">Iraq<\/option><option value=\"74\">Ireland<\/option><option value=\"323\">Isle of Man<\/option><option value=\"75\">Israel<\/option><option value=\"76\">Italy<\/option><option value=\"202\">Jamaica<\/option><option value=\"78\">Japan<\/option><option value=\"288\">Jersey  (Channel Islands)<\/option><option value=\"79\">Jordan<\/option><option value=\"80\">Kazakhstan<\/option><option value=\"81\">Kenya<\/option><option value=\"203\">Kiribati<\/option><option value=\"82\">Kuwait<\/option><option value=\"83\">Kyrgyzstan<\/option><option value=\"84\">Lao People's Democratic Republic<\/option><option value=\"85\">Latvia<\/option><option value=\"86\">Lebanon<\/option><option value=\"87\">Lesotho<\/option><option value=\"88\">Liberia<\/option><option value=\"281\">Libya<\/option><option value=\"90\">Liechtenstein<\/option><option value=\"91\">Lithuania<\/option><option value=\"92\">Luxembourg<\/option><option value=\"208\">Macau<\/option><option value=\"93\">Macedonia<\/option><option value=\"94\">Madagascar<\/option><option value=\"95\">Malawi<\/option><option value=\"96\">Malaysia<\/option><option value=\"97\">Maldives<\/option><option value=\"98\">Mali<\/option><option value=\"99\">Malta<\/option><option value=\"207\">Marshall Islands<\/option><option value=\"210\">Martinique<\/option><option value=\"100\">Mauritania<\/option><option value=\"212\">Mauritius<\/option><option value=\"241\">Mayotte<\/option><option value=\"101\">Mexico<\/option><option value=\"102\">Moldova, Republic of<\/option><option value=\"103\">Monaco<\/option><option value=\"104\">Mongolia<\/option><option value=\"290\">Montenegro<\/option><option value=\"294\">Montserrat<\/option><option value=\"105\">Morocco<\/option><option value=\"106\">Mozambique<\/option><option value=\"242\">Myanmar<\/option><option value=\"107\">Namibia<\/option><option value=\"108\">Nepal<\/option><option value=\"109\">Netherlands<\/option><option value=\"110\">Netherlands Antilles<\/option><option value=\"213\">New Caledonia<\/option><option value=\"111\">New Zealand<\/option><option value=\"112\">Nicaragua<\/option><option value=\"113\">Niger<\/option><option value=\"114\">Nigeria<\/option><option value=\"217\">Niue<\/option><option value=\"214\">Norfolk Island<\/option><option value=\"272\">North Korea<\/option><option value=\"116\">Norway<\/option><option value=\"117\">Oman<\/option><option value=\"118\">Pakistan<\/option><option value=\"222\">Palau<\/option><option value=\"282\">Palestine<\/option><option value=\"119\">Panama<\/option><option value=\"219\">Papua New Guinea<\/option><option value=\"120\">Paraguay<\/option><option value=\"121\">Peru<\/option><option value=\"122\">Philippines<\/option><option value=\"221\">Pitcairn<\/option><option value=\"123\">Poland<\/option><option value=\"124\">Portugal<\/option><option value=\"126\">Qatar<\/option><option value=\"315\">Republic of Kosovo<\/option><option value=\"127\">Reunion<\/option><option value=\"128\">Romania<\/option><option value=\"129\">Russia<\/option><option value=\"130\">Rwanda<\/option><option value=\"205\">Saint Kitts and Nevis<\/option><option value=\"206\">Saint Lucia<\/option><option value=\"324\">Saint Martin<\/option><option value=\"237\">Saint Vincent and the Grenadines<\/option><option value=\"132\">Samoa (Independent)<\/option><option value=\"227\">San Marino<\/option><option value=\"255\">Sao Tome and Principe<\/option><option value=\"133\">Saudi Arabia<\/option><option value=\"134\">Senegal<\/option><option value=\"326\">Serbia<\/option><option value=\"135\">Seychelles<\/option><option value=\"136\">Sierra Leone<\/option><option value=\"137\">Singapore<\/option><option value=\"302\">Sint Maarten<\/option><option value=\"138\">Slovakia<\/option><option value=\"139\">Slovenia<\/option><option value=\"223\">Solomon Islands<\/option><option value=\"140\">Somalia<\/option><option value=\"141\">South Africa<\/option><option value=\"257\">South Georgia and the South Sandwich Islands<\/option><option value=\"142\">South Korea<\/option><option value=\"311\">South Sudan<\/option><option value=\"143\">Spain<\/option><option value=\"144\">Sri Lanka<\/option><option value=\"293\">Sudan<\/option><option value=\"146\">Suriname<\/option><option value=\"225\">Svalbard and Jan Mayen Islands<\/option><option value=\"147\">Swaziland<\/option><option value=\"148\">Sweden<\/option><option value=\"149\">Switzerland<\/option><option value=\"285\">Syria<\/option><option value=\"152\">Taiwan<\/option><option value=\"260\">Tajikistan<\/option><option value=\"153\">Tanzania<\/option><option value=\"154\">Thailand<\/option><option value=\"233\">Timor-Leste<\/option><option value=\"155\">Togo<\/option><option value=\"232\">Tonga<\/option><option value=\"234\">Trinidad and Tobago<\/option><option value=\"156\">Tunisia<\/option><option value=\"157\">Turkey<\/option><option value=\"158\">Turkmenistan<\/option><option value=\"287\">Turks & Caicos Islands<\/option><option value=\"159\">Uganda<\/option><option value=\"161\">Ukraine<\/option><option value=\"162\">United Arab Emirates<\/option><option value=\"262\">United Kingdom<\/option><option value=\"163\">Uruguay<\/option><option value=\"165\">Uzbekistan<\/option><option value=\"239\">Vanuatu<\/option><option value=\"166\">Vatican City State (Holy See)<\/option><option value=\"167\">Venezuela<\/option><option value=\"168\">Vietnam<\/option><option value=\"169\">Virgin Islands (British)<\/option><option value=\"238\">Virgin Islands (U.S.)<\/option><option value=\"188\">Western Sahara<\/option><option value=\"170\">Yemen<\/option><option value=\"173\">Zambia<\/option><option value=\"174\">Zimbabwe<\/option><\/select>\n\t<\/div>\n<\/div>\n<div class=\"mc-field-group\">\n\t<label for=\"mce-OTHER\">Anything else you would like us to know? <\/label>\n\t<input type=\"text\" value=\"\" name=\"OTHER\" class=\"\" id=\"mce-OTHER\">\n<\/div>\n<div class=\"mc-field-group input-group\">\n    <strong>Survivor Status <\/strong>\n    <ul><li><input type=\"radio\" value=\"TTI Survivor\" name=\"SURV\" id=\"mce-SURV-0\"><label for=\"mce-SURV-0\">TTI Survivor<\/label><\/li>\n<li><input type=\"radio\" value=\"Ally\" name=\"SURV\" id=\"mce-SURV-1\"><label for=\"mce-SURV-1\">Ally<\/label><\/li>\n<li><input type=\"radio\" value=\"Parent of Survivor\" name=\"SURV\" id=\"mce-SURV-2\"><label for=\"mce-SURV-2\">Parent of Survivor<\/label><\/li>\n<li><input type=\"radio\" value=\"Former TTI Staff\" name=\"SURV\" id=\"mce-SURV-3\"><label for=\"mce-SURV-3\">Former TTI Staff<\/label><\/li>\n<\/ul>\n<\/div>\n<div class=\"mc-field-group input-group\">\n    <strong>I am at least 18 years old and able to volunteer. <\/strong>\n    <ul><li><input type=\"radio\" value=\"16384\" name=\"group[81066]\" id=\"mce-group[81066]-81066-0\"><label for=\"mce-group[81066]-81066-0\">Yes, I agree<\/label><\/li>\n<\/ul>\n<\/div>\n<div class=\"mc-field-group input-group\">\n    <strong>Preferred Volunteer Role(s) <\/strong>\n    <ul><li><input type=\"checkbox\" value=\"32768\" name=\"group[81074][32768]\" id=\"mce-group[81074]-81074-0\"><label for=\"mce-group[81074]-81074-0\">Academic Research<\/label><\/li>\n<li><input type=\"checkbox\" value=\"65536\" name=\"group[81074][65536]\" id=\"mce-group[81074]-81074-1\"><label for=\"mce-group[81074]-81074-1\">Program Investigation<\/label><\/li>\n<li><input type=\"checkbox\" value=\"131072\" name=\"group[81074][131072]\" id=\"mce-group[81074]-81074-2\"><label for=\"mce-group[81074]-81074-2\">Information Storage\/Database<\/label><\/li>\n<li><input type=\"checkbox\" value=\"262144\" name=\"group[81074][262144]\" id=\"mce-group[81074]-81074-3\"><label for=\"mce-group[81074]-81074-3\">Legislation<\/label><\/li>\n<li><input type=\"checkbox\" value=\"524288\" name=\"group[81074][524288]\" id=\"mce-group[81074]-81074-4\"><label for=\"mce-group[81074]-81074-4\">Advocacy<\/label><\/li>\n<li><input type=\"checkbox\" value=\"1048576\" name=\"group[81074][1048576]\" id=\"mce-group[81074]-81074-5\"><label for=\"mce-group[81074]-81074-5\">Clinicians\/Therapists<\/label><\/li>\n<li><input type=\"checkbox\" value=\"2097152\" name=\"group[81074][2097152]\" id=\"mce-group[81074]-81074-6\"><label for=\"mce-group[81074]-81074-6\">Social Media<\/label><\/li>\n<li><input type=\"checkbox\" value=\"4194304\" name=\"group[81074][4194304]\" id=\"mce-group[81074]-81074-7\"><label for=\"mce-group[81074]-81074-7\">Writers\/Editors<\/label><\/li>\n<li><input type=\"checkbox\" value=\"8388608\" name=\"group[81074][8388608]\" id=\"mce-group[81074]-81074-8\"><label for=\"mce-group[81074]-81074-8\">Web 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