{"id":3333,"date":"2019-02-16T22:05:11","date_gmt":"2019-02-16T22:05:11","guid":{"rendered":"https:\/\/www.higarcia.com\/us-ifjc2024\/?page_id=3333"},"modified":"2024-06-04T08:14:15","modified_gmt":"2024-06-04T08:14:15","slug":"intake-form","status":"publish","type":"page","link":"https:\/\/www.higarcia.com\/us-ifjc2024\/intake-form\/","title":{"rendered":"Intake Form"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row wrap_container=&#8221;yes&#8221;][vc_column][vc_custom_heading text=&#8221;Online Intake Form&#8221; font_container=&#8221;tag:h1|text_align:left&#8221; use_theme_fonts=&#8221;yes&#8221;][vc_column_text]<span style=\"font-size: 20px;\">If you are able and to help IFJC better assist you, please fill out and submit the following online intake form to have IFJC consider taking on your family law case on a pro bono (free) basis, or find an attorney that will take your case on a pro bono or low bono (low cost) basis.&nbsp;<\/span><\/p>\n<p><span style=\"font-size: 20px;\">Contact us at (206) 849-6885 to get help.<\/span>[\/vc_column_text][vc_column_text]<span style=\"color: #ff0000;\">* = required answers<\/span>[\/vc_column_text]\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f3332-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"3332\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/us-ifjc2024\/wp-json\/wp\/v2\/pages\/3333#wpcf7-f3332-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"3332\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.0.6\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f3332-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/div>\n<div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div> \n<h2 class=\"short\"><\/h2>\n<div class=\"row\">\n    <div class=\"col-lg-4\">\n        <div class=\"form-group\">\n            <label for=\"contact-first\">First Name <span style=\"color: #ff0000;\">*<\/span><\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"first-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" id=\"contact-name\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-name\" \/><\/span>\n        <\/div>\n    <\/div>\n    <div class=\"col-lg-4\">\n        <div class=\"form-group\">\n            <label for=\"contact-middle\">Middle Name<\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"middle-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"middle-name\" \/><\/span>\n        <\/div>\n    <\/div>\n    <div class=\"col-lg-4\">\n        <div class=\"form-group\">\n            <label for=\"contact-last\">Last Name <span style=\"color: #ff0000;\">*<\/span><\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"last-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"last-name\" \/><\/span>\n        <\/div>\n    <\/div>\n    <div class=\"col-lg-6\">\n        <div class=\"form-group\">\n            <label for=\"contact-email\">Email address <span style=\"color: #ff0000;\">*<\/span><\/label>\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 form-control\" id=\"contact-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span>\n        <\/div>\n    <\/div>\n    <div class=\"col-lg-6\">\n        <div class=\"form-group\">\n            <label for=\"alt-email\">Alternative Email address<\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"alt-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-text wpcf7-validates-as-email form-control\" id=\"alt-email\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"alt-email\" \/><\/span>\n        <\/div>\n    <\/div>\n\n    <div class=\"col-lg-6\">\n        <div class=\"form-group\">\n            <label for=\"your-phone\">Main Phone Number <span style=\"color: #ff0000;\">*<\/span><\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"your-phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" id=\"contact-phone\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-phone\" \/><\/span>\n        <\/div>\n    <\/div>\n    <div class=\"col-lg-6\">\n        <div class=\"form-group\">\n            <label for=\"alt-phone\">Alternative Phone Number<\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"alt-phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" id=\"alt-phone\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"alt-phone\" \/><\/span>\n        <\/div>\n    <\/div>\n\n    <div class=\"col-lg-12\">\n        <div class=\"form-group\">\n            <label for=\"your-address\">What is your physical address (street, city state zip)?<\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"your-address\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" id=\"your-address\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-address\" \/><\/span>\n        <\/div>\n    <\/div>\n\n    <div class=\"col-lg-6\">\n        <div class=\"form-group\">\n            <label for=\"your-county\">What county do you live in? <span style=\"color: #ff0000;\">*<\/span><\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"your-county\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" id=\"your-county\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-county\" \/><\/span>\n        <\/div>\n    <\/div>\n\n\n\n    <div class=\"col-lg-12\">\n        <div class=\"form-group\">\n            <label for=\"wa-resident\">How long have you been a resident of WA state? <span style=\"color: #ff0000;\">*<\/span><\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"wa-resident\"><span class=\"wpcf7-form-control wpcf7-radio form-control\" id=\"wa-resident\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"wa-resident\" value=\"Less than 6 months\" \/><span class=\"wpcf7-list-item-label\">Less than 6 months<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"wa-resident\" value=\"6 months \u2013 1 year\" \/><span class=\"wpcf7-list-item-label\">6 months \u2013 1 year<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"wa-resident\" value=\"1-2 years\" \/><span class=\"wpcf7-list-item-label\">1-2 years<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"wa-resident\" value=\"2-5 years\" \/><span class=\"wpcf7-list-item-label\">2-5 years<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"wa-resident\" value=\"5-10 years\" \/><span class=\"wpcf7-list-item-label\">5-10 years<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"wa-resident\" value=\"10 years or longer\" \/><span class=\"wpcf7-list-item-label\">10 years or longer<\/span><\/span><\/span><\/span>\n        <\/div>\n    <\/div>\n\n    <div class=\"col-lg-12\">\n        <div class=\"form-group\">\n            <label for=\"us-resident\">How long have you lived in the U.S.? <span style=\"color: #ff0000;\">*<\/span><\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"us-resident\"><span class=\"wpcf7-form-control wpcf7-radio form-control\" id=\"us-resident\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"us-resident\" value=\"Less than 6 months\" \/><span class=\"wpcf7-list-item-label\">Less than 6 months<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"us-resident\" value=\"6 months \u2013 1 year\" \/><span class=\"wpcf7-list-item-label\">6 months \u2013 1 year<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"us-resident\" value=\"1-2 years\" \/><span class=\"wpcf7-list-item-label\">1-2 years<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"us-resident\" value=\"2-5 years\" \/><span class=\"wpcf7-list-item-label\">2-5 years<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"us-resident\" value=\"5-10 years\" \/><span class=\"wpcf7-list-item-label\">5-10 years<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"us-resident\" value=\"10 years or longer\" \/><span class=\"wpcf7-list-item-label\">10 years or longer<\/span><\/span><\/span><\/span>\n        <\/div>\n    <\/div>\n\n    <div class=\"col-lg-6\">\n        <div class=\"form-group\">\n            <label for=\"contact-age\">Age <span style=\"color: #ff0000;\">*<\/span><\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"your-age\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-required wpcf7-validates-as-number form-control\" id=\"contact-age\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"your-age\" \/><\/span>\n        <\/div>\n    <\/div>\n\n    <div class=\"col-lg-6\">\n        <div class=\"form-group\">\n            <label for=\"how-referred\">How did you hear about IFJC?<\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"how-referred\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" id=\"how-referred\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"how-referred\" \/><\/span>\n        <\/div>\n    <\/div>\n\n    <div class=\"col-lg-12\">\n        <div class=\"form-group\">\n            <label for=\"proficient-level\">What is your English proficiency? <span style=\"color: #ff0000;\">*<\/span><\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"proficient-level\"><span class=\"wpcf7-form-control wpcf7-radio form-control\" id=\"proficient-level\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"proficient-level\" value=\"Absolute Beginner\" \/><span class=\"wpcf7-list-item-label\">Absolute Beginner<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"proficient-level\" value=\"Conversational\" \/><span class=\"wpcf7-list-item-label\">Conversational<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"proficient-level\" value=\"Business Level\" \/><span class=\"wpcf7-list-item-label\">Business Level<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"proficient-level\" value=\"Fluent\" \/><span class=\"wpcf7-list-item-label\">Fluent<\/span><\/span><\/span><\/span>\n        <\/div>\n    <\/div>\n\n    <div class=\"col-lg-6\">\n        <div class=\"form-group\">\n            <label>Do you feel comfortable talking with attorneys in English? <span style=\"color: #ff0000;\">*<\/span><\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"english-comfortableness\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"english-comfortableness\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"english-comfortableness\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"english-comfortableness\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n        <\/div>\n    <\/div>\n\n<div class=\"col-lg-6\">\n        <div class=\"form-group\">\n            <label for=\"your-nativelanguage\">What is your native language? <span style=\"color: #ff0000;\">*<\/span><\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"your-nativelanguage\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" id=\"your-nativelanguage\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-nativelanguage\" \/><\/span>\n        <\/div>\n    <\/div>\n\n\n\n    <div class=\"col-lg-4\">\n        <div class=\"form-group\">\n            <label>Are you currently employed? <span style=\"color: #ff0000;\">*<\/span><\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"current-employed\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"current-employed\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"current-employed\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"current-employed\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n        <\/div>\n    <\/div>\n\n    <div class=\"col-lg-8\">\n        <div class=\"form-group\">\n            <label for=\"employer-name\">If \u201cYes\u201d, name your employer<\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"employer-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" id=\"employer-name\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"employer-name\" \/><\/span>\n        <\/div>\n    <\/div>\n\n    <div class=\"col-lg-12\">\n        <div class=\"form-group\">\n            <label for=\"your-annual-income\">Your annual gross Income <span style=\"color: #ff0000;\">*<\/span><\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"your-annual-income\"><span class=\"wpcf7-form-control wpcf7-radio form-control\" id=\"your-annual-income\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"your-annual-income\" value=\"Less than $10,000\" \/><span class=\"wpcf7-list-item-label\">Less than $10,000<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"your-annual-income\" value=\"$10,000 - $19,999\" \/><span class=\"wpcf7-list-item-label\">$10,000 - $19,999<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"your-annual-income\" value=\"$20,000 - $29,999\" \/><span class=\"wpcf7-list-item-label\">$20,000 - $29,999<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"your-annual-income\" value=\"$30,000 \u2013 $39,999\" \/><span class=\"wpcf7-list-item-label\">$30,000 \u2013 $39,999<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"your-annual-income\" value=\"$40,000 \u2013 $69,999\" \/><span class=\"wpcf7-list-item-label\">$40,000 \u2013 $69,999<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"your-annual-income\" value=\"$70,000 \u2013 $100,000\" \/><span class=\"wpcf7-list-item-label\">$70,000 \u2013 $100,000<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"your-annual-income\" value=\"More than $100,000\" \/><span class=\"wpcf7-list-item-label\">More than $100,000<\/span><\/span><\/span><\/span>\n        <\/div>\n    <\/div>\n\n   <div class=\"col-lg-3\">\n        <div class=\"form-group\">\n            <label>Are you married? <span style=\"color: #ff0000;\">*<\/span><\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"marriage-status\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"marriage-status\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"marriage-status\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"marriage-status\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n        <\/div>\n    <\/div>\n\n    <div class=\"col-lg-4\">\n        <div class=\"form-group\">\n            <label for=\"marriage-years\">If \u201cYes\u201d, how many years have you been married?<\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"marriage-years\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" id=\"marriage-years\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"marriage-years\" \/><\/span>\n        <\/div>\n    <\/div>\n\n    <div class=\"col-lg-5\">\n        <div class=\"form-group\">\n            <label for=\"living-together\">If \u201cNo\u201d, how many years have you lived with your partner?<\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"living-together\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" id=\"living-together\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"living-together\" \/><\/span>\n        <\/div>\n    <\/div>\n\n\n\n    <div class=\"col-lg-6\">\n        <div class=\"form-group\">\n            <label for=\"partner-first\">Spouse \/ Partner\u2019s First Name <span style=\"color: #ff0000;\">*<\/span><\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"partner-first\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" id=\"partner-first\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"partner-first\" \/><\/span>\n        <\/div>\n    <\/div>\n\n    <div class=\"col-lg-6\">\n        <div class=\"form-group\">\n            <label for=\"partner-last\">Spouse \/ Partner\u2019s Last Name <span style=\"color: #ff0000;\">*<\/span><\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"partner-last\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" id=\"partner-last\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"partner-last\" \/><\/span>\n        <\/div>\n    <\/div>\n\n    <div class=\"col-lg-12\">\n        <div class=\"form-group\">\n            <label for=\"partner-address\">What is your Spouse \/ Partner\u2019s physical address (street, city state zip)?<\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"partner-address\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" id=\"partner-address\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"partner-address\" \/><\/span>\n        <\/div>\n    <\/div>\n\n    <div class=\"col-lg-6\">\n        <div class=\"form-group\">\n            <label for=\"partner-county\">What county does your Spouse \/ Partner live in?<\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"partner-county\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" id=\"partner-county\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"partner-county\" \/><\/span>\n        <\/div>\n    <\/div>\n\n\n\n    <div class=\"col-lg-4\">\n        <div class=\"form-group\">\n            <label>Is your spouse \/ partner currently employed? <span style=\"color: #ff0000;\">*<\/span><\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"partner-employed\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"partner-employed\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"partner-employed\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"partner-employed\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n        <\/div>\n    <\/div>\n\n    <div class=\"col-lg-8\">\n        <div class=\"form-group\">\n            <label for=\"partner-employer\">If \u201cYes\u201d, name your spouse \/ partner\u2019s employer<\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"partner-employer\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" id=\"partner-employer\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"partner-employer\" \/><\/span>\n        <\/div>\n    <\/div>\n\n    <div class=\"col-lg-12\">\n        <div class=\"form-group\">\n            <label for=\"spouses-annual-income\">Your spouse\/partners annual gross Income <span style=\"color: #ff0000;\">*<\/span><\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"spouses-annual-income\"><span class=\"wpcf7-form-control wpcf7-radio form-control\" id=\"spouses-annual-income\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"spouses-annual-income\" value=\"Less than $10,000\" \/><span class=\"wpcf7-list-item-label\">Less than $10,000<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"spouses-annual-income\" value=\"$10,000 - $19,999\" \/><span class=\"wpcf7-list-item-label\">$10,000 - $19,999<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"spouses-annual-income\" value=\"$20,000 - $29,999\" \/><span class=\"wpcf7-list-item-label\">$20,000 - $29,999<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"spouses-annual-income\" value=\"$30,000 \u2013 $39,999\" \/><span class=\"wpcf7-list-item-label\">$30,000 \u2013 $39,999<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"spouses-annual-income\" value=\"$40,000 \u2013 $69,999\" \/><span class=\"wpcf7-list-item-label\">$40,000 \u2013 $69,999<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"spouses-annual-income\" value=\"$70,000 \u2013 $100,000\" \/><span class=\"wpcf7-list-item-label\">$70,000 \u2013 $100,000<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"spouses-annual-income\" value=\"More than $100,000\" \/><span class=\"wpcf7-list-item-label\">More than $100,000<\/span><\/span><\/span><\/span>\n        <\/div>\n    <\/div>\n\n    <div class=\"col-lg-12\">\n        <div class=\"form-group\">\n            <label>Are you currently living with your spouse\/partner? <span style=\"color: #ff0000;\">*<\/span><\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"living-spouse\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"contact-radios\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"living-spouse\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"living-spouse\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n        <\/div>\n    <\/div>\n\n    <div class=\"col-lg-6\">\n        <div class=\"form-group\">\n            <label for=\"number-child\">How many children do you have? <span style=\"color: #ff0000;\">*<\/span><\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"number-child\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-required wpcf7-validates-as-number form-control\" id=\"number-child\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"number-child\" \/><\/span>\n        <\/div>\n    <\/div>\n\n    <div class=\"col-lg-6\">\n        <div class=\"form-group\">\n            <label for=\"age-child\">If you have children, how old are they?<\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"age-child\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number form-control\" id=\"age-child\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"age-child\" \/><\/span>\n        <\/div>\n    <\/div>\n\n    <div class=\"col-lg-12\">\n        <div class=\"form-group\">\n            <label>Do you own any real property? <span style=\"color: #ff0000;\">*<\/span><\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"own-property\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"own-property\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"own-property\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"own-property\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n        <\/div>\n    <\/div>\n\n    <div class=\"col-lg-12\">\n        <div class=\"form-group\">\n            <label>Have you experienced Domestic Violence (DV)? <span style=\"color: #ff0000;\">*<\/span><\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"dv-experienced\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"dv-experienced\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"dv-experienced\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"dv-experienced\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n        <\/div>\n    <\/div>\n\n    <div class=\"col-lg-12\">\n        <div class=\"form-group\">\n            <label for=\"dv-describe\">If \u201cYes\u201d, please describe your Domestic Violence (DV) experience.<\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"dv-describe\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea form-control\" id=\"dv-describe\" aria-invalid=\"false\" name=\"dv-describe\"><\/textarea><\/span>\n        <\/div>\n    <\/div>\n\n\n    <div class=\"col-lg-12\">\n        <div class=\"form-group\">\n            <label>Has a divorce petition been filled with a court? <span style=\"color: #ff0000;\">*<\/span><\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"dv-petition\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"dv-petition\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"dv-petition\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"dv-petition\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"dv-petition\" value=\"Don&#039;t Know\" \/><span class=\"wpcf7-list-item-label\">Don&#039;t Know<\/span><\/span><\/span><\/span>\n        <\/div>\n    <\/div>\n\n    <div class=\"col-lg-12\">\n        <div class=\"form-group\">\n            <label for=\"dv-petition-when\">If \u201cYes\u201d, when and by whom?<\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"dv-petition-when\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" id=\"dv-petition-when\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"dv-petition-when\" \/><\/span>\n        <\/div>\n    <\/div>\n\n\n\n    <div class=\"col-lg-12\">\n        <div class=\"form-group\">\n            <label for=\"other-information\">Other Information<\/label>\n            <span class=\"wpcf7-form-control-wrap\" data-name=\"other-information\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea form-control\" id=\"other-information\" aria-invalid=\"false\" name=\"other-information\"><\/textarea><\/span>\n        <\/div>\n    <\/div>\n\n    <hr>\n\n    <div class=\"col-lg-12\">\n        <div class=\"form-group\">\n            <input class=\"wpcf7-form-control wpcf7-submit has-spinner btn btn-primary btn-lg\" type=\"submit\" value=\"Submit Online Intake Form\" \/>\n        <\/div>\n    <\/div>\n<\/div>\n<div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n[\/vc_column][\/vc_row][vc_row wrap_container=&#8221;yes&#8221;][vc_column][vc_separator color=&#8221;custom&#8221; gap=&#8221;tall&#8221; gradient=&#8221;yes&#8221;][vc_custom_heading text=&#8221;Privacy&#8221; font_container=&#8221;tag:h5|text_align:left&#8221; use_theme_fonts=&#8221;yes&#8221; el_class=&#8221;m-b-sm&#8221;][vc_column_text]When you submit an online application, your private information is sent to IFJC over a secure Internet connection. As a potential client of IFJC, the information you give us will be treated as confidential under the Washington Rules of Professional Conduct. We will not share your information without your consent or prior notice. The information you give us will speed up the application process. However, submission of the application does not create an attorney-client relationship, and IFJC does not guarantee that it will accept such relationship.&nbsp;<\/p>\n<p>If you are using a public computer or computer that does not belong to you, close the browser when you are done so that other users cannot view your application. Also, you may want to delete the browsing history.[\/vc_column_text][vc_custom_heading text=&#8221;Safety&#8221; font_container=&#8221;tag:h5|text_align:left&#8221; use_theme_fonts=&#8221;yes&#8221; el_class=&#8221;m-b-sm&#8221;][vc_column_text]IF YOU FEAR FOR YOUR SAFETY we do NOT recommend you use this application. Information entered online may be stored in the computer you use, and may be found by someone skilled. If you are concerned for your safety, you can apply for help over the telephone by calling IFJC at 1-206-849-6885.<\/p>\n<p><strong>Limitations<\/strong><\/p>\n<p>IFJC may only take cases for Washington residents that meet certain low-income levels. Also, IFJC receives requests beyond its current operational capacity, and therefore may deny service due to its capacity constraints. If IFJC cannot take your case, it will try to refer you to another organization or attorney.<\/p>\n<p><span style=\"font-size: 22px;\"><strong>SUBMISSION OF THIS FORM DOES NOT CREATE AN ATTORNEY-CLIENT RELATIONSHIP.<\/strong><\/span>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row wrap_container=&#8221;yes&#8221;][vc_column][vc_custom_heading text=&#8221;Online Intake Form&#8221; font_container=&#8221;tag:h1|text_align:left&#8221; use_theme_fonts=&#8221;yes&#8221;][vc_column_text]If you are able and to help IFJC better assist you, please fill out and submit the following online intake form to have IFJC consider taking on your family law case on a pro bono (free) basis, or find an attorney that will take your case on a pro [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"ngg_post_thumbnail":0,"footnotes":""},"class_list":["post-3333","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.higarcia.com\/us-ifjc2024\/wp-json\/wp\/v2\/pages\/3333","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.higarcia.com\/us-ifjc2024\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.higarcia.com\/us-ifjc2024\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.higarcia.com\/us-ifjc2024\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.higarcia.com\/us-ifjc2024\/wp-json\/wp\/v2\/comments?post=3333"}],"version-history":[{"count":3,"href":"https:\/\/www.higarcia.com\/us-ifjc2024\/wp-json\/wp\/v2\/pages\/3333\/revisions"}],"predecessor-version":[{"id":3354,"href":"https:\/\/www.higarcia.com\/us-ifjc2024\/wp-json\/wp\/v2\/pages\/3333\/revisions\/3354"}],"wp:attachment":[{"href":"https:\/\/www.higarcia.com\/us-ifjc2024\/wp-json\/wp\/v2\/media?parent=3333"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}