{"id":4016,"date":"2020-02-04T20:44:20","date_gmt":"2020-02-04T20:44:20","guid":{"rendered":"https:\/\/nau.edu\/sherc\/?page_id=4016"},"modified":"2025-11-20T19:36:15","modified_gmt":"2025-11-20T19:36:15","slug":"cec-video-series-registration-for-recordings","status":"publish","type":"page","link":"https:\/\/legacy.nau.edu\/sherc\/cec-video-series-registration-for-recordings\/","title":{"rendered":"CEC Video series registration (for recordings)"},"content":{"rendered":"<h1>CEC Video Series Registration Form<\/h1>\n<p>Please use the following form to access pre-recorded videos of CEC Video Series. All of the videos can be accessed after submitting the registration form.<\/p>\n<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 e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_15' style='display:none'><form method='post' enctype='multipart\/form-data'  id='gform_15'  action='\/sherc\/wp-json\/wp\/v2\/pages\/4016' data-formid='15' >\n                        <div class='gform-body gform_body'><ul id='gform_fields_15' class='gform_fields top_label form_sublabel_below description_above'><li id=\"field_15_1\"  class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_15_1\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_15_1'>\n                            \n                            <span id='input_15_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_15_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_15_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_15_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_15_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_15_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><\/li><li id=\"field_15_3\"  class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_15_3\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_15_3_container'>\n                                <span id='input_15_3_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='text' name='input_3' id='input_15_3' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_15_3' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_15_3_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='text' name='input_3_2' id='input_15_3_2' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_15_3_2' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><\/li><li id=\"field_15_11\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_15_11\"><label class='gfield_label gform-field-label' for='input_15_11' >Zip code (place of employment or academic institution)<\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_15_11' type='text' value='' class='medium' maxlength='5'     aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_15_5\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_15_5\"><label class='gfield_label gform-field-label'  >Please indicate if you would like to receive CEC-related news and events<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_15_5'>\n\t\t\t<li class='gchoice gchoice_15_5_0'>\n\t\t\t\t<input name='input_5' type='radio' value='Yes, I would like to receive CEC news and events information'  id='choice_15_5_0'    \/>\n\t\t\t\t<label for='choice_15_5_0' id='label_15_5_0' class='gform-field-label gform-field-label--type-inline'>Yes, I would like to receive CEC news and events information<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_15_5_1'>\n\t\t\t\t<input name='input_5' type='radio' value='No, I prefer not to  receive CEC news and events information'  id='choice_15_5_1'    \/>\n\t\t\t\t<label for='choice_15_5_1' id='label_15_5_1' class='gform-field-label gform-field-label--type-inline'>No, I prefer not to  receive CEC news and events information<\/label>\n\t\t\t<\/li><\/ul><\/div><\/fieldset><\/li><li id=\"field_15_7\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_15_7\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Role<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='gfield_description' id='gfield_description_15_7'>What is your role? Check all choices that apply. If you are a community member, please check which sector.<\/div><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_15_7'><li class='gchoice gchoice_15_7_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.1' type='checkbox'  value='Researcher'  id='choice_15_7_1'   aria-describedby=\"gfield_description_15_7\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_15_7_1' id='label_15_7_1' class='gform-field-label gform-field-label--type-inline'>Researcher<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_15_7_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.2' type='checkbox'  value='Undergraduate student'  id='choice_15_7_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_15_7_2' id='label_15_7_2' class='gform-field-label gform-field-label--type-inline'>Undergraduate student<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_15_7_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.3' type='checkbox'  value='Graduate student'  id='choice_15_7_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_15_7_3' id='label_15_7_3' class='gform-field-label gform-field-label--type-inline'>Graduate student<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_15_7_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.4' type='checkbox'  value='Post-doctoral student'  id='choice_15_7_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_15_7_4' id='label_15_7_4' class='gform-field-label gform-field-label--type-inline'>Post-doctoral student<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_15_7_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.5' type='checkbox'  value='Community member in education'  id='choice_15_7_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_15_7_5' id='label_15_7_5' class='gform-field-label gform-field-label--type-inline'>Community member in education<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_15_7_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.6' type='checkbox'  value='Community member in health'  id='choice_15_7_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_15_7_6' id='label_15_7_6' class='gform-field-label gform-field-label--type-inline'>Community member in health<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_15_7_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.7' type='checkbox'  value='Community member in housing'  id='choice_15_7_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_15_7_7' id='label_15_7_7' class='gform-field-label gform-field-label--type-inline'>Community member in housing<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_15_7_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.8' type='checkbox'  value='Community member in transportation'  id='choice_15_7_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_15_7_8' id='label_15_7_8' class='gform-field-label gform-field-label--type-inline'>Community member in transportation<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_15_7_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.9' type='checkbox'  value='Community member in economic development'  id='choice_15_7_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_15_7_9' id='label_15_7_9' class='gform-field-label gform-field-label--type-inline'>Community member in economic development<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_15_7_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.11' type='checkbox'  value='Other'  id='choice_15_7_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_15_7_11' id='label_15_7_11' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/fieldset><\/li><li id=\"field_15_13\"  class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_15_13\"><label class='gfield_label gform-field-label' for='input_15_13' >If other, what is your role?<\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_15_13' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_15_12\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_15_12\"><label class='gfield_label gform-field-label' for='input_15_12' >Please list the name of the entity you represent (you can name more than one).<\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_15_12' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_15_9\"  class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_15_9\"><label class='gfield_label gform-field-label' for='input_15_9' >To which educational institution do you belong?<\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_15_9' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_15_8\"  class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_15_8\"><label class='gfield_label gform-field-label' for='input_15_8' >Why are you accessing the video?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_8' id='input_15_8' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Personal' >Personal<\/option><option value='Educational (For instructional use)' >Educational (For instructional use)<\/option><option value='Professional' >Professional<\/option><option value='Other' >Other<\/option><option value='' selected='selected'><\/option><\/select><\/div><\/li><li id=\"field_15_10\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_15_10\"><label class='gfield_label gform-field-label' for='input_15_10' >What is your specific purpose for accessing the video series?<\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_15_10' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_15_14\"  class=\"gfield gfield--type-captcha field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_15_14\"><label class='gfield_label gform-field-label' for='input_15_14' >CAPTCHA<\/label><div id='input_15_14' class='ginput_container ginput_recaptcha' data-sitekey='6LcGbgEaAAAAAIFp2sWhYr0ySvMKRcpJmKWYL9f4'  data-theme='light' data-tabindex='0'  data-badge=''><\/div><\/li><li id=\"field_15_15\"  class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_15_15\"><label class='gfield_label gform-field-label' for='input_15_15' >Comments<\/label><div class='gfield_description' id='gfield_description_15_15'>This field is for validation purposes and should be left unchanged.<\/div><div class='ginput_container'><input name='input_15' id='input_15_15' type='text' value='' \/><\/div><\/li><\/ul><\/div>\n        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_15' class='gform_button button' value='Submit'  onclick='if(window[\"gf_submitting_15\"]){return false;}  window[\"gf_submitting_15\"]=true;  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_15\"]){return false;} window[\"gf_submitting_15\"]=true;  jQuery(\"#gform_15\").trigger(\"submit\",[true]); }' \/> \n            <input type='hidden' class='gform_hidden' name='is_submit_15' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='15' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_15' value='WyJbXSIsIjhjZDQ2MTNhODhlNWJhYjVlNzY5ZjJiYzgxNGRkYWM3Il0=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_target_page_number_15' id='gform_target_page_number_15' value='0' \/>\n            <input type='hidden' class='gform_hidden' name='gform_source_page_number_15' id='gform_source_page_number_15' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div><script type=\"text\/javascript\">\ngform.initializeOnLoaded( function() {gformInitSpinner( 15, 'https:\/\/legacy.nau.edu\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery('#gform_ajax_frame_15').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_15');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_15').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 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contents;}setTimeout(function(){jQuery('#gform_wrapper_15').replaceWith(confirmation_content);jQuery(document).trigger('gform_confirmation_loaded', [15]);window['gf_submitting_15'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_15').text());}, 50);}else{jQuery('#gform_15').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger('gform_post_render', [15, current_page]);gform.utils.trigger({ event: 'gform\/postRender', native: false, data: { formId: 15, currentPage: current_page } });} );} );\n<\/script>\n\n<hr \/>\n<h6><em>SHERC is a grant-funded initiative of the Center for Community Health and Engaged Research at Northern Arizona University. SHERC is supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under Award Number U54MD012388.<\/em><\/h6>\n<!-- shortcode-right-column -->\n<div class=\"shortcode-right-column\" >\n    <div class=\"shortcode-right-column__container\">\n<!-- shortcode-contact -->\n<div class=\"shortcode-contact\">\n    <div class=\"contact-header\">\n        <h3>Issues with form submission?<\/h3>\n    <\/div>\n    <div class=\"contact-body\">\n                <a href=\"mailto:SHERC@nau.edu\" aria-label=\"Issues with form submission?: Email Address\" title=\"Email Address\">\n            <div class=\"contact-icon-container\">\n                <i class=\"fas fa-envelope\" aria-hidden=\"true\"><\/i>\n                <span class=\"sr-only\">Email:<\/span>\n            <\/div>\n            <div class=\"contact-email\">SHERC&#8203;@nau.edu<\/div>\n        <\/a>\n                    <\/div>\n<\/div>\n\n\n<\/div>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>CEC Video Series Registration Form Please use the following form to access pre-recorded videos of CEC Video Series. All of the videos can be accessed after submitting the registration form. SHERC is a grant-funded initiative of the Center for Community Health and Engaged Research at Northern Arizona University. SHERC is supported by the National Institute [&hellip;]<\/p>\n","protected":false},"author":286,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"ring_central_script_selection":""},"acf":[],"_links":{"self":[{"href":"https:\/\/legacy.nau.edu\/sherc\/wp-json\/wp\/v2\/pages\/4016"}],"collection":[{"href":"https:\/\/legacy.nau.edu\/sherc\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/legacy.nau.edu\/sherc\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/legacy.nau.edu\/sherc\/wp-json\/wp\/v2\/users\/286"}],"replies":[{"embeddable":true,"href":"https:\/\/legacy.nau.edu\/sherc\/wp-json\/wp\/v2\/comments?post=4016"}],"version-history":[{"count":10,"href":"https:\/\/legacy.nau.edu\/sherc\/wp-json\/wp\/v2\/pages\/4016\/revisions"}],"predecessor-version":[{"id":9893,"href":"https:\/\/legacy.nau.edu\/sherc\/wp-json\/wp\/v2\/pages\/4016\/revisions\/9893"}],"wp:attachment":[{"href":"https:\/\/legacy.nau.edu\/sherc\/wp-json\/wp\/v2\/media?parent=4016"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}