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<!DOCTYPE html><!-- [et_pb_line_break_holder] --><html><!-- [et_pb_line_break_holder] --><head><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><title><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --></title><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --></head><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><div id="JCDRC" class="ltr"><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><form id="form179" name="form179" class="wufoo topLabel page" accept-charset="UTF-8" autocomplete="off" enctype="multipart/form-data" method="post"<!-- [et_pb_line_break_holder] --> action="https://jdcambassadors.wufoo.com/forms/z1tvj1yy0aappl2/#public"><!-- [et_pb_line_break_holder] --> <!-- [et_pb_line_break_holder] --><header id="header" class="info"><!-- [et_pb_line_break_holder] --><h2 class="0"></h2><!-- [et_pb_line_break_holder] --><div class="0"></div><!-- [et_pb_line_break_holder] --></header><ul><!-- [et_pb_line_break_holder] --><li id="foli10" class="notranslate "><!-- [et_pb_line_break_holder] --><!--<!-- [et_pb_line_break_holder] --><label class="desc" id="title10" for="Field10"><!-- [et_pb_line_break_holder] -->Name<!-- [et_pb_line_break_holder] --><span id="req_10" class="req">*</span><!-- [et_pb_line_break_holder] --></label><!-- [et_pb_line_break_holder] -->--><!-- [et_pb_line_break_holder] --><span><!-- [et_pb_line_break_holder] --><input id="Field10" name="Field10" type="text" class="FName FullName JCDRInput" value="" size="8" tabindex="1" placeholder="First Name" required /><!-- [et_pb_line_break_holder] --><!--<label for="Field10">First</label>--><!-- [et_pb_line_break_holder] --></span><!-- [et_pb_line_break_holder] --><span><!-- [et_pb_line_break_holder] --><input id="Field11" name="Field11" type="text" class="FLame FullName JCDRInput" value="" size="14" tabindex="2" placeholder="Last Name" required /><!-- [et_pb_line_break_holder] --><!--<label for="Field11">Last</label>--><!-- [et_pb_line_break_holder] --></span><!-- [et_pb_line_break_holder] --></li><!-- [et_pb_line_break_holder] --><li id="foli3" class="notranslate "><!-- [et_pb_line_break_holder] --><!--<!-- [et_pb_line_break_holder] --><label class="desc" id="title3" for="Field3"><!-- [et_pb_line_break_holder] -->Email<!-- [et_pb_line_break_holder] --><span id="req_3" class="req">*</span><!-- [et_pb_line_break_holder] --></label><!-- [et_pb_line_break_holder] -->--><!-- [et_pb_line_break_holder] --><div><!-- [et_pb_line_break_holder] --><input id="Field3" name="Field3" type="email" spellcheck="false" class="EmailAd JCDRInput" value="" maxlength="255" tabindex="3" placeholder="Email Address" required /><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --></li><!-- [et_pb_line_break_holder] --><li id="foli5" class="notranslate "><!-- [et_pb_line_break_holder] --><!--<!-- [et_pb_line_break_holder] --><label class="desc" id="title5" for="Field5"><!-- [et_pb_line_break_holder] -->Subject of Inquiry<!-- [et_pb_line_break_holder] --></label><!-- [et_pb_line_break_holder] -->--><!-- [et_pb_line_break_holder] --><div><!-- [et_pb_line_break_holder] --><input id="Field5" name="Field5" type="text" class="SubOI JCDRInput" value="" maxlength="255" tabindex="4" onkeyup="" placeholder="Subject of Inquiry" /><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --></li><!-- [et_pb_line_break_holder] --><li id="foli4"<!-- [et_pb_line_break_holder] -->class="notranslate "><!-- [et_pb_line_break_holder] --><!--<!-- [et_pb_line_break_holder] --> <label class="desc" id="title4" for="Field4"><!-- [et_pb_line_break_holder] -->Message<!-- [et_pb_line_break_holder] --></label><!-- [et_pb_line_break_holder] -->--><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><div><!-- [et_pb_line_break_holder] --><textarea id="Field4"<!-- [et_pb_line_break_holder] -->name="Field4"<!-- [et_pb_line_break_holder] -->class="MessageF JCDRInput"<!-- [et_pb_line_break_holder] -->spellcheck="true"<!-- [et_pb_line_break_holder] -->rows="10" cols="50"<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->tabindex="5"<!-- [et_pb_line_break_holder] -->onkeyup=""<!-- [et_pb_line_break_holder] -->placeholder="Message"<!-- [et_pb_line_break_holder] --> ></textarea><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --></li> <li class="buttons "><!-- [et_pb_line_break_holder] --><div><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> <input id="saveForm" name="saveForm" class="JCDRSubmit"<!-- [et_pb_line_break_holder] --> type="submit" value="Submit"<!-- [et_pb_line_break_holder] --> /></div><!-- [et_pb_line_break_holder] --></li><!-- [et_pb_line_break_holder] --><li class="hide"><!-- [et_pb_line_break_holder] --><label for="comment">Do Not Fill This Out</label><!-- [et_pb_line_break_holder] --><textarea name="comment" id="comment" rows="1" cols="1"></textarea><!-- [et_pb_line_break_holder] --><input type="hidden" id="idstamp" name="idstamp" value="ju7XELhB4ESUQFaqztYpkOLNyzyzI8Mcy10Nkcr+I+Q=" /><!-- [et_pb_line_break_holder] --></li><!-- [et_pb_line_break_holder] --></ul><!-- [et_pb_line_break_holder] --></form><!-- [et_pb_line_break_holder] --> <!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --></div><!--container--><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><style><!-- [et_pb_line_break_holder] -->#JCDRC .hide{<!-- [et_pb_line_break_holder] --> <!-- [et_pb_line_break_holder] --> display:none<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> #JCDRC ul{<!-- [et_pb_line_break_holder] --> list-style: none;<!-- [et_pb_line_break_holder] --> width: 80%;<!-- [et_pb_line_break_holder] -->margin:0 auto;<!-- [et_pb_line_break_holder] -->padding:50px 0;<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> <!-- [et_pb_line_break_holder] --> #JCDRC .JCDRInput {<!-- [et_pb_line_break_holder] --> margin-bottom: 15px;<!-- [et_pb_line_break_holder] --> border-radius: 5px;<!-- [et_pb_line_break_holder] --> outline: none;<!-- [et_pb_line_break_holder] --> border: 1px solid;<!-- [et_pb_line_break_holder] --> padding: 15px;<!-- [et_pb_line_break_holder] -->font-size:16px;<!-- [et_pb_line_break_holder] --> <!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] -->#JCDRC .FullName {<!-- [et_pb_line_break_holder] --> width: 100%;<!-- [et_pb_line_break_holder] --> <!-- [et_pb_line_break_holder] --> <!-- [et_pb_line_break_holder] -->}<!-- [et_pb_line_break_holder] --> <!-- [et_pb_line_break_holder] -->#JCDRC .SubOI,#JCDRC .EmailAd{<!-- [et_pb_line_break_holder] --> <!-- [et_pb_line_break_holder] --> width:100%<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> <!-- [et_pb_line_break_holder] -->#JCDRC .MessageF {<!-- [et_pb_line_break_holder] --> width: 100%;<!-- [et_pb_line_break_holder] -->}<!-- [et_pb_line_break_holder] -->#JCDRC{<!-- [et_pb_line_break_holder] -->background:white;<!-- [et_pb_line_break_holder] -->}<!-- [et_pb_line_break_holder] --> <!-- [et_pb_line_break_holder] -->#JCDRC .JCDRSubmit {<!-- [et_pb_line_break_holder] --> font-size: 20px;<!-- [et_pb_line_break_holder] --> border-radius: 5px;<!-- [et_pb_line_break_holder] --> border: 1px solid;<!-- [et_pb_line_break_holder] --> padding: 10px 20px;<!-- [et_pb_line_break_holder] --> cursor: pointer;<!-- [et_pb_line_break_holder] -->}<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --></style>