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	<title>9.26.26 Hudson Valley Capital District Event - Family BBQ | New York Chapter of the American College of Physicians</title>


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			<p class="form-instructions"><h2 style="text-align: center;">NYACP Hudson Valley District Event</h2>

<h2 style="text-align: center;">&quot;GRILL, GATHER &amp; GIVE: An End-of-Summer BBQ &amp; Food Drive&quot;</h2>

<h2 style="text-align: center;">RSVP&nbsp;Form</h2>

<p style="text-align: justify;">We&#39;re excited to have you join us on September 26th!&nbsp;</p>

<p style="text-align: justify;">Food donations for Cooperstown Food Pantry can be brought directly to the event, or a monetary donation can be made here. Please fill out the online donation as shown below to ensure the funds are allocated properly. Thank you in advance for your generous support!</p>

<p style="text-align: justify;"><img src="https://www.nyacp.org/images/image(4).png" style="width: 300px; height: 222px;" /></p>
</p>
		

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	// Thibault 2/11/06 added init function called at page load, plus validation that required fields are completed before submit.  should help with problems with the back button and credit cards,  issue 30102
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	}

	window.onload = new Function("init()"); //set init function to run at page load

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			var jsDesc = "ACP Membership #";
			
			
			var jsDesc = "First Name";
			
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			var jsDesc = "How did you hear about this event?";
			
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			var jsDesc = "How many adults will attend?";
			
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				val = obj.value;
				if (obj.value == "") {
					arrReqMissing[arrReqMissing.length] = jsDesc;
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			var jsDesc = "How many children 12 AND UNDER will attend?";
			
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				val = obj.value;
				if (obj.value == "") {
					arrReqMissing[arrReqMissing.length] = jsDesc;
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			var jsDesc = "How many children OLDER THAN 12 will attend?";
			
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			var jsDesc = "Please note any dietary restrictions\r\n(Hold ctrl to select multiple)";
			
			
			var jsDesc = "Other";
			
			
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	  			title: 'Missing required fields',
	  			html: true,
	  			text: errStr,
	  			animation: 'slide-from-top',
	  			type: 'info',
	  			confirmButtonText: 'Ok',
	  			confirmButtonColor: '#337ab7'
	  		});
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			  			title: 'Maximum allowable length',
			  			html: true,
			  			text: "One or more field responses exceeds the maximum allowable length of 2147483647 characters. Please adjust your responses and re-submit.",
			  			animation: 'slide-from-top',
			  			type: 'info',
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		 			return false;
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	  			html: true,
	  			text: "Your request is processing. Please do not click Submit more than once.",
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	  			type: 'info',
	  			confirmButtonText: 'Ok',
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		document.getElementById(itemID).value = 1;
		// now call the calcTotalFix function to recaculate the total amount due
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		var processedRadioButtons = [];	/// reset array every time this function is called
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			if (myFieldObj.value == '') { myFieldObj.value = 0; }
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			value = myFieldObj.value;
			fieldID = myFieldObj.getAttribute('id');
			price = myFieldObj.getAttribute('price');

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				  			title: 'Numbers only',
				  			html: true,
				  			text: "Open Prices must be numbers only, no formatting is allowed.",
				  			animation: 'slide-from-top',
				  			type: 'info',
				  			confirmButtonText: 'Ok',
				  			confirmButtonColor: '#337ab7'
				  		});
						myFieldObj.value = 0;
						return;
					}
					calculatedValue = parseFloat(value);
					// console.log('fieldName: ' + fieldName + ' / value: ' + value + ' fieldID: ' + fieldID + ' / price: ' + price + ' / calculatedValue: ' + calculatedValue);
				} else {
					if (!IsNumeric(value)) {
						//alert("Price fields only allow numbers.");
						swal({
				  			title: 'Price fields',
				  			html: true,
				  			text: "Price fields only allow numbers.",
				  			animation: 'slide-from-top',
				  			type: 'info',
				  			confirmButtonText: 'Ok',
				  			confirmButtonColor: '#337ab7'
				  		});
						myFieldObj.value = 0;
						return;
					}
					myVal = parseFloat(value);
					// console.log('in parseint with 10 - fieldName: ' + fieldName + ' / value: ' + value + ' fieldID: ' + fieldID + ' / price: ' + price + ' / myVal: ' + myVal);
					calculatedValue = myVal * parseFloat(price);

				}
			}


			// console.log('Field id: ' + fieldID + ' / Fieldtype: ' + fieldtype + ' / Field name: ' + fieldName + ' / value: ' + value + ' / Price: ' + price + ' / Calculated Field Total: ' + calculatedValue);
			updateTotal = updateTotal + calculatedValue;
		}

		// update hidden total amount
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		// console.log('The updateTotal is now: ' + updateTotal);
		
		
		// update total value with formatted amount
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		if ($('#ordertotal_work').length > 0) {
            $('#ordertotal_work').val(updateTotal.toFixed(2));
        }
        
        if ($('#pmt_method').length > 0) {
        	$('#pmt_method').val('');
        }
        $('.paymentProfileRadio').prop('checked', false);
        $('.card').removeClass('active');
        
		// need to update the cc_info tag fields...
		if (typeof(checkTotal) == "function") { checkTotal(); }
	}

	/* remove after confirming ok without it - 8/8/13 CJV */
	function calcTotal(myField){
		thisVal = myField.value;
		// alert(thisVal);
		if (thisVal == '') {
			thisVal = 0;
			myField.value = 0;
			}
			if (!IsNumeric(myField.value)) {
				//alert('Please enter only numbers or decimal points in a price field');
				swal({
		  			title: 'Price field',
		  			html: true,
		  			text: "Please enter only numbers or decimal points in a price field.",
		  			animation: 'slide-from-top',
		  			type: 'info',
		  			confirmButtonText: 'Ok',
		  			confirmButtonColor: '#337ab7'
		  		});
				myField.value = 0;
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				// get the current total
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				// now backout the prior value from the total
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					}
				// add the open price to the total
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				// update hidden total amount
				document.iform.hiddentotal.value = updateTotal;
				
					
				// update total value with formatted amount
				document.iform.total.value = formatCurrency(updateTotal);
		checkTotal(); // need to update the cc_info tag fields...
	}
	/* */

	function setOpenPriceInput(thisField,thisPrice){
		if(thisPrice == ''){
			thisField.priorval = 0;
		} else {
			thisField.priorval = thisPrice;
		}
	}

	
		var div_bottom_moved = false;

		function addLoadEvent(func) {
 			var oldonload = window.onload;
  			if (typeof window.onload != 'function') {
    			window.onload = func;
  			}
  			else {
    			window.onload = function() {
      				if (oldonload) {
        				oldonload();
      				}
      				func();
    			}
  			}
 		}

		addLoadEvent(calcTotalFix);
	
</script>

	
<style>
.has-error {
	color: #f70404 !important;
}
.has-error input {
	border: 1px solid #f70404 !important;
}
</style>


<script>
	function checkInvalidCharacter(objName){
		var obj = document.iform[objName];
		var strFileName = obj.value.replace('C:\\fakepath\\','');
		iTemp = strFileName.indexOf(":");
		
		if (iTemp > -1) {
			swal({
	  			title: 'Invalid character',
	  			html: true,
	  			text: "Invalid character ':' found in file name. Please change the file name before attempting to upload this file.",
	  			animation: 'slide-from-top',
	  			type: 'info',
	  			confirmButtonText: 'Ok',
	  			confirmButtonColor: '#337ab7'
	  		});
			obj.value = '';
			return false;
		}
		else {
			iTemp = obj.value.indexOf(",");
			if (iTemp > -1) {
				swal({
		  			title: 'Invalid character',
		  			html: true,
		  			text: "Invalid character ',' found in file name. Please change the file name before attempting to upload this file.",
		  			animation: 'slide-from-top',
		  			type: 'info',
		  			confirmButtonText: 'Ok',
		  			confirmButtonColor: '#337ab7'
		  		});
				obj.value = '';
				return false;
			}
		}
	}
	function clearRadio(rd) {
		if (document.iform) {
			var v;
			var ln;
			var ev;
			submitted = 0;
			v = "document.iform." + rd + ".length";
			ln = eval(v);
			// This will ensure we uncheck if there is only 1 radio button..
			v = "document.iform." + rd + ".checked = false;";
			ev = eval(v);
			// Now loop through the list of radio buttons and uncheck them all
			for (i=0;i<ln;i++) {
				v = "document.iform." + rd + "[" + i + "].checked = false;";
				//console.log(v);
				ev = eval(v);
			}
			calcTotalFix();
		}
	}
</script>


<div class="form_layout_wrapper" style="max-width:940px;" >

	
			<!-- The inner div, for the sake of IE -->
			<div id="layout_form_item" style="clear:both;border:0px solid orange;margin:0 0 0px 0;padding:0;min-height:0px;">
		

		<div id="form-item-13141" class="layout form item outer row-1 item-13141 row_num-20 row_pos-640 rowlength-1 type-Text" style="clear:both;;position:relative;">

			<div class="inner">

				
							ACP Membership #
					

							<input type="text"
								
									id="response_1"
									name="response_1"
								
								
								 style="width:200px;"
								
									
                                            value=""
									    
										
								class="form-control type-Text row-1 item-13141"
							><!-- input -->

							
				<input type="hidden" name="question_1" value="ACP Membership #">
				<INPUT TYPE="hidden" NAME="response_1_question_id" VALUE="13141">
				<INPUT TYPE="hidden" NAME="question_type_1" value="Text">
				<INPUT TYPE="hidden" NAME="label_1" value="ACP Membership">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
				</div> <!-- /The inner div, for the sake of IE -->
			
			<!-- The inner div, for the sake of IE -->
			<div id="layout_form_item" style="clear:both;border:0px solid orange;margin:0 0 0px 0;padding:0;min-height:0px;">
		

		<div id="form-item-13123" class="layout form item outer row-2 item-13123 row_num-40 row_pos-640 rowlength-3 type-Text" style="clear:both;;position:relative;">

			<div class="inner">

				
							First Name<span class="text-danger"> *</span>
					

							<input type="text"
								
									id="response_2"
									name="response_2"
								
								
								 style="width:146px;"
								
									
                                            value=""
									    
										
								class="form-control type-Text row-2 item-13123"
							><!-- input -->

							
						<INPUT
							TYPE="hidden"
							NAME="response_2_required"
							VALUE="The field First Name is required. Please click your browser's back button and provide this value.">
					

				<input type="hidden" name="question_2" value="First Name">
				<INPUT TYPE="hidden" NAME="response_2_question_id" VALUE="13123">
				<INPUT TYPE="hidden" NAME="question_type_2" value="Text">
				<INPUT TYPE="hidden" NAME="label_2" value="First Name">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
		<div id="form-item-13120" class="layout form item outer row-3 item-13120 row_num-40 row_pos-1280 rowlength-3 type-Text" style=";position:relative;">

			<div class="inner">

				
							Last Name<span class="text-danger"> *</span>
					

							<input type="text"
								
									id="response_3"
									name="response_3"
								
								
								 style="width:146px;"
								
									
                                            value=""
									    
										
								class="form-control type-Text row-3 item-13120"
							><!-- input -->

							
						<INPUT
							TYPE="hidden"
							NAME="response_3_required"
							VALUE="The field Last Name is required. Please click your browser's back button and provide this value.">
					

				<input type="hidden" name="question_3" value="Last Name">
				<INPUT TYPE="hidden" NAME="response_3_question_id" VALUE="13120">
				<INPUT TYPE="hidden" NAME="question_type_3" value="Text">
				<INPUT TYPE="hidden" NAME="label_3" value="Last Name">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
		<div id="form-item-13121" class="layout form item outer row-4 item-13121 row_num-40 row_pos-1920 rowlength-3 type-Text" style=";position:relative;">

			<div class="inner">

				
							Credentials
					

							<input type="text"
								
									id="response_4"
									name="response_4"
								
								
								 style="width:80px;"
								
									
                                            value=""
									    
										
								class="form-control type-Text row-4 item-13121"
							><!-- input -->

							
				<input type="hidden" name="question_4" value="Credentials">
				<INPUT TYPE="hidden" NAME="response_4_question_id" VALUE="13121">
				<INPUT TYPE="hidden" NAME="question_type_4" value="Text">
				<INPUT TYPE="hidden" NAME="label_4" value="Cred.">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
				</div> <!-- /The inner div, for the sake of IE -->
			
			<!-- The inner div, for the sake of IE -->
			<div id="layout_form_item" style="clear:both;border:0px solid orange;margin:0 0 0px 0;padding:0;min-height:0px;">
		

		<div id="form-item-13124" class="layout form item outer row-5 item-13124 row_num-60 row_pos-640 rowlength-1 type-Text" style="clear:both;;position:relative;">

			<div class="inner">

				
							Preferred email:<span class="text-danger"> *</span>
					

							<input type="text"
								
									id="response_5"
									name="response_5"
								
								
								 style="width:447px;"
								
									
                                            value=""
									    
										
								class="form-control type-Text row-5 item-13124"
							><!-- input -->

							
						<INPUT
							TYPE="hidden"
							NAME="response_5_required"
							VALUE="The field Preferred email: is required. Please click your browser's back button and provide this value.">
					

				<input type="hidden" name="question_5" value="Preferred email: ">
				<INPUT TYPE="hidden" NAME="response_5_question_id" VALUE="13124">
				<INPUT TYPE="hidden" NAME="question_type_5" value="Text">
				<INPUT TYPE="hidden" NAME="label_5" value="Preferred email">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
				</div> <!-- /The inner div, for the sake of IE -->
			
			<!-- The inner div, for the sake of IE -->
			<div id="layout_form_item" style="clear:both;border:0px solid orange;margin:0 0 0px 0;padding:0;min-height:0px;">
		

		<div id="form-item-13122" class="layout form item outer row-6 item-13122 row_num-80 row_pos-640 rowlength-1 type-MultiSelect" style="clear:both;width:100%;position:relative;">

			<div class="inner">

				
							How did you hear about this event?<span class="text-danger"> *</span>
					

								<select
									id="response_6"
									name="response_6"
									
									
										size="3" multiple="multiple"
									
									
									class="form-control type-MultiSelect row-6 item-13122"
									>
									
									
										<option value="NYACP Website" >NYACP Website</option>
									
										<option value="NYACP Email" >NYACP Email</option>
									
										<option value="Event Flyer" >Event Flyer</option>
									
										<option value="Colleague/Friend" >Colleague/Friend</option>
									
										<option value="Instagram" >Instagram</option>
									
										<option value="LinkedIn" >LinkedIn</option>
									
										<option value="Facebook" >Facebook</option>
									
										<option value="Other
" >Other
</option>
									
								</select>
							
							
						<INPUT
							TYPE="hidden"
							NAME="response_6_required"
							VALUE="The field How did you hear about this event? is required. Please click your browser's back button and provide this value.">
					

				<input type="hidden" name="question_6" value="How did you hear about this event?">
				<INPUT TYPE="hidden" NAME="response_6_question_id" VALUE="13122">
				<INPUT TYPE="hidden" NAME="question_type_6" value="MultiSelect">
				<INPUT TYPE="hidden" NAME="label_6" value="How Did You Hear">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
				</div> <!-- /The inner div, for the sake of IE -->
			
			<!-- The inner div, for the sake of IE -->
			<div id="layout_form_item" style="clear:both;border:0px solid orange;margin:0 0 0px 0;padding:0;min-height:0px;">
		

		<div id="form-item-13183" class="layout form item outer row-7 item-13183 row_num-100 row_pos-640 rowlength-1 type-Text" style="clear:both;;position:relative;">

			<div class="inner">

				
							How many adults will attend?<span class="text-danger"> *</span>
					

							<input type="text"
								
									id="response_7"
									name="response_7"
								
								
								 style="width:80px;"
								
									
                                            value=""
									    
										
								class="form-control type-Text row-7 item-13183"
							><!-- input -->

							
						<INPUT
							TYPE="hidden"
							NAME="response_7_required"
							VALUE="The field How many adults will attend? is required. Please click your browser's back button and provide this value.">
					

				<input type="hidden" name="question_7" value="How many adults will attend?">
				<INPUT TYPE="hidden" NAME="response_7_question_id" VALUE="13183">
				<INPUT TYPE="hidden" NAME="question_type_7" value="Text">
				<INPUT TYPE="hidden" NAME="label_7" value="Number adults">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
				</div> <!-- /The inner div, for the sake of IE -->
			
			<!-- The inner div, for the sake of IE -->
			<div id="layout_form_item" style="clear:both;border:0px solid orange;margin:0 0 0px 0;padding:0;min-height:0px;">
		

		<div id="form-item-13184" class="layout form item outer row-8 item-13184 row_num-120 row_pos-640 rowlength-1 type-Text" style="clear:both;;position:relative;">

			<div class="inner">

				
							How many children 12 AND UNDER will attend?<span class="text-danger"> *</span>
					

							<input type="text"
								
									id="response_8"
									name="response_8"
								
								
								 style="width:80px;"
								
									
                                            value=""
									    
										
								class="form-control type-Text row-8 item-13184"
							><!-- input -->

							
						<INPUT
							TYPE="hidden"
							NAME="response_8_required"
							VALUE="The field How many children 12 AND UNDER will attend? is required. Please click your browser's back button and provide this value.">
					

				<input type="hidden" name="question_8" value="How many children 12 AND UNDER will attend?">
				<INPUT TYPE="hidden" NAME="response_8_question_id" VALUE="13184">
				<INPUT TYPE="hidden" NAME="question_type_8" value="Text">
				<INPUT TYPE="hidden" NAME="label_8" value="How many children?">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
				</div> <!-- /The inner div, for the sake of IE -->
			
			<!-- The inner div, for the sake of IE -->
			<div id="layout_form_item" style="clear:both;border:0px solid orange;margin:0 0 0px 0;padding:0;min-height:0px;">
		

		<div id="form-item-13185" class="layout form item outer row-9 item-13185 row_num-140 row_pos-640 rowlength-1 type-Text" style="clear:both;;position:relative;">

			<div class="inner">

				
							How many children OLDER THAN 12 will attend?<span class="text-danger"> *</span>
					

							<input type="text"
								
									id="response_9"
									name="response_9"
								
								
								 style="width:80px;"
								
									
                                            value=""
									    
										
								class="form-control type-Text row-9 item-13185"
							><!-- input -->

							
						<INPUT
							TYPE="hidden"
							NAME="response_9_required"
							VALUE="The field How many children OLDER THAN 12 will attend? is required. Please click your browser's back button and provide this value.">
					

				<input type="hidden" name="question_9" value="How many children OLDER THAN 12 will attend?">
				<INPUT TYPE="hidden" NAME="response_9_question_id" VALUE="13185">
				<INPUT TYPE="hidden" NAME="question_type_9" value="Text">
				<INPUT TYPE="hidden" NAME="label_9" value="Number of teens">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
				</div> <!-- /The inner div, for the sake of IE -->
			
			<!-- The inner div, for the sake of IE -->
			<div id="layout_form_item" style="clear:both;border:0px solid orange;margin:0 0 0px 0;padding:0;min-height:0px;">
		

		<div id="form-item-13146" class="layout form item outer row-10 item-13146 row_num-160 row_pos-640 rowlength-1 type-MultiSelect" style="clear:both;width:100%;position:relative;">

			<div class="inner">

				
							Please note any dietary restrictions
(Hold ctrl to select multiple)
					

								<select
									id="response_10"
									name="response_10"
									
									
										size="3" multiple="multiple"
									
									
									class="form-control type-MultiSelect row-10 item-13146"
									>
									
									
										<option value="Kosher" >Kosher</option>
									
										<option value="Vegan" >Vegan</option>
									
										<option value="Vegetarian" >Vegetarian</option>
									
										<option value="Pescatarian" >Pescatarian</option>
									
										<option value="Nut Allergy" >Nut Allergy</option>
									
										<option value="Gluten Free" >Gluten Free</option>
									
										<option value="Lactose Intolerant" >Lactose Intolerant</option>
									
								</select>
							
							
				<input type="hidden" name="question_10" value="Please note any dietary restrictions
(Hold ctrl to select multiple)">
				<INPUT TYPE="hidden" NAME="response_10_question_id" VALUE="13146">
				<INPUT TYPE="hidden" NAME="question_type_10" value="MultiSelect">
				<INPUT TYPE="hidden" NAME="label_10" value="Dietary Restrictions">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
				</div> <!-- /The inner div, for the sake of IE -->
			
			<!-- The inner div, for the sake of IE -->
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		<div id="form-item-13147" class="layout form item outer row-11 item-13147 row_num-180 row_pos-640 rowlength-1 type-Text" style="clear:both;;position:relative;">

			<div class="inner">

				
							Other:
					

							<input type="text"
								
									id="response_11"
									name="response_11"
								
								
								 style="width:400px;"
								
									
                                            value=""
									    
										
								class="form-control type-Text row-11 item-13147"
							><!-- input -->

							
				<input type="hidden" name="question_11" value="Other:">
				<INPUT TYPE="hidden" NAME="response_11_question_id" VALUE="13147">
				<INPUT TYPE="hidden" NAME="question_type_11" value="Text">
				<INPUT TYPE="hidden" NAME="label_11" value="Other">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
	</div><!-- /The inner div, for the sake of IE -->

	
	<input type="hidden" id="hasOpenPriceField" name="hasOpenPriceField" value="0">

	
</div><!-- /form_layout_wrapper -->


		<div id="_ssdiv2" style="display:none">
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			<input type="hidden" id="fld_form_overrideid" name="form_overrideID" value="0">
			
			<input type="hidden" id="fld_ss_form_testid" name="ss_form_testid" value="0" />
			<div id="_ssdiv">
				<p style="background-color: blue"><input type="text" name="ss_address2" value="" /></p>
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		</div>
		
			<input type="hidden" name="form_isEdit" value="0">
		
	
		<div id="div_bottom" style="clear:both;">
			
			
				<input type="hidden" name="useCaptcha" value="0">
			
			
				<INPUT TYPE="hidden" NAME="send_mail_ind" VALUE="0">
				<INPUT TYPE="hidden" NAME="no_opt_out" VALUE="1">
			
	
			<div id="frm_submit_button">
				<br />
				<button class="btn btn-primary" type="button" data-loading-text="Please wait..." id="submitBtn"
					
						onclick="startValidate();"
					
				>Submit Form</button>
				<br /><br />
			</div>
	
			
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			</div>
			
	
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				</div>
			
	
				<div id="frm_ssl_copy_bottom"><p>Your form submission WILL be encrypted using SSL to ensure your privacy.</p></div>
			
	
		</div><!-- div_bottom -->
	
		
	</form>
</div>


	</div>


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</div>


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