{"id":1760,"date":"2016-05-03T14:39:56","date_gmt":"2016-05-03T18:39:56","guid":{"rendered":"https:\/\/www.bumc.bu.edu\/comm\/?page_id=1760"},"modified":"2016-06-21T14:57:17","modified_gmt":"2016-06-21T18:57:17","slug":"service-request-form","status":"publish","type":"page","link":"https:\/\/www.bumc.bu.edu\/comm\/design-and-photography-services\/service-request-form\/","title":{"rendered":"Service Request Form"},"content":{"rendered":"<p><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_6' style='display:none'>\n                        <div class='gform_heading'>\n                            <p class='gform_description'><h3><strong>Please fill out this form and \"SUBMIT\".  <\/strong><\/h3><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_6'  action='\/comm\/wp-json\/wp\/v2\/pages\/1760' data-formid='6' >\n                        <div class='gform-body gform_body'><ul id='gform_fields_6' class='gform_fields top_label form_sublabel_above description_below'><li id=\"field_6_8\"  class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_above gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_8\"><label class='gfield_label gform-field-label' for='input_6_8' >Describe Your Design or Photo Request (Required)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_8' id='input_6_8' class='textarea medium'   maxlength='999'  aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_6_69\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_69\"><h4>After you submit your project description and contact details, we will respond as soon as possible.  To review some of our work, please visit-<br> \n<a href=\"http:\/\/www.bumc.bu.edu\/comm\/design-and-photography-services\/design-photo-samples\/\" target=\"_blank\">Design and Photo Samples<\/a><\/h4><strong>Design Services <\/strong><\/br>Our design services include a wide range of visual media for web or print, and we generally charge an hourly rate of $65. <br><br><strong>Photography Services <\/strong><\/br>For specific photo items, please select below.<\/li><li id=\"field_6_54\"  class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_above gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_54\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Check the Photography Service You Need<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_6_54'><li class='gchoice gchoice_6_54_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.1' type='checkbox'  value='ERAS Photo'  id='choice_6_54_1'   aria-describedby=\"gfield_description_6_54\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_6_54_1' id='label_6_54_1' class='gform-field-label gform-field-label--type-inline'>ERAS Photo<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_54_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.2' type='checkbox'  value='Digital Portrait'  id='choice_6_54_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_54_2' id='label_6_54_2' class='gform-field-label gform-field-label--type-inline'>Digital Portrait<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_54_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.3' type='checkbox'  value='BMC Directory Photo'  id='choice_6_54_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_54_3' id='label_6_54_3' class='gform-field-label gform-field-label--type-inline'>BMC Directory Photo<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_54_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.4' type='checkbox'  value='Passport Photo'  id='choice_6_54_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_54_4' id='label_6_54_4' class='gform-field-label gform-field-label--type-inline'>Passport Photo<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_54_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.5' type='checkbox'  value='Special Event or Group Photo'  id='choice_6_54_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_54_5' id='label_6_54_5' class='gform-field-label gform-field-label--type-inline'>Special Event or Group Photo<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_54_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.6' type='checkbox'  value='Laboratory, Science or Product Photography'  id='choice_6_54_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_54_6' id='label_6_54_6' class='gform-field-label gform-field-label--type-inline'>Laboratory, Science or Product Photography<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_54_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.7' type='checkbox'  value='Environmental \/ Exterior Campus Photography'  id='choice_6_54_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_54_7' id='label_6_54_7' class='gform-field-label gform-field-label--type-inline'>Environmental \/ Exterior Campus Photography<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_54_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.8' type='checkbox'  value='Photography Prints'  id='choice_6_54_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_54_8' id='label_6_54_8' class='gform-field-label gform-field-label--type-inline'>Photography Prints<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_6_54'>Group photography | $90\/hour;  \nLocation photography | $100\/hour (30 minute minimum charge)\n<\/div><\/li><li id=\"field_6_24\"  class=\"gfield gfield--type-fileupload field_sublabel_above gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_24\"><label class='gfield_label gform-field-label' for='gform_browse_button_6_24' >File Upload<\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_6_24' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_6_24&quot;,&quot;container&quot;:&quot;gform_multifile_upload_6_24&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_6_24&quot;,&quot;filelist&quot;:&quot;gform_preview_6_24&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/www.bumc.bu.edu\\\/comm\\\/?gf_page=0827c6337de4ac6&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/www.bumc.bu.edu\\\/comm\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/www.bumc.bu.edu\\\/comm\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;doc,docx,gif,eps,jpeg,jpg,tif,tiff,png,pdf,ppt,pptx,psd,xls,xlsx,zip,dmg,rar,7z&quot;}],&quot;max_file_size&quot;:&quot;104857600b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:6,&quot;field_id&quot;:24},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;50&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_6_24&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_6_24' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_6_24' class='button gform_button_select_files' aria-describedby=\"gfield_upload_rules_6_24 gfield_description_6_24\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_6_24'>Accepted file types: doc, docx, gif, eps, jpeg, jpg, tif, tiff, png, pdf, ppt, pptx, psd, xls, xlsx, zip, dmg, rar, 7z, Max. file size: 100 MB, Max. files: 50.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_6_24'><\/ul> <!-- Leave <ul> empty to support CSS :empty selector. --><\/div><div id='gform_preview_6_24' class='ginput_preview_list'><\/div><div class='gfield_description' id='gfield_description_6_24'><em>You can send us files totaling 100 MBs in size<\/em><\/div><\/li><li id=\"field_6_15\"  class=\"gfield gfield--type-name gfield_contains_required field_sublabel_above gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_15\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Contact Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/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_6_15'>\n                            \n                            <span id='input_6_15_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_6_15_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_15.3' id='input_6_15_3' value=''   aria-required='true'     \/>\n                                                <\/span>\n                            \n                            <span id='input_6_15_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_6_15_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_15.6' id='input_6_15_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/li><li id=\"field_6_16\"  class=\"gfield gfield--type-email gfield_contains_required field_sublabel_above gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_16\"><label class='gfield_label gform-field-label' for='input_6_16' >Contact Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_16' id='input_6_16' type='text' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_6_3\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_above gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_3\"><label class='gfield_label gform-field-label' for='input_6_3' >BU \/ BMC Department Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_6_3' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_17\"  class=\"gfield gfield--type-phone gfield_contains_required field_sublabel_above gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_17\"><label class='gfield_label gform-field-label' for='input_6_17' >Office Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_17' id='input_6_17' type='text' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_39\"  class=\"gfield gfield--type-phone field_sublabel_above gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_39\"><label class='gfield_label gform-field-label' for='input_6_39' >Fax No.<\/label><div class='ginput_container ginput_container_phone'><input name='input_39' id='input_6_39' type='text' value='' class='medium'    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_18\"  class=\"gfield gfield--type-phone field_sublabel_above gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_18\"><label class='gfield_label gform-field-label' for='input_6_18' >Other Phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_18' id='input_6_18' type='text' value='' class='medium'    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_31\"  class=\"gfield gfield--type-name gfield_contains_required field_sublabel_above gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_31\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Administrative \/ Financial Manager<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/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_6_31'>\n                            \n                            <span id='input_6_31_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_6_31_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_31.3' id='input_6_31_3' value=''   aria-required='true'     \/>\n                                                <\/span>\n                            \n                            <span id='input_6_31_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_6_31_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_31.6' id='input_6_31_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/li><li id=\"field_6_36\"  class=\"gfield gfield--type-phone gfield_contains_required field_sublabel_above gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_36\"><label class='gfield_label gform-field-label' for='input_6_36' >Administrative \/ Financial Manager&#039;s Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_36' id='input_6_36' type='text' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_68\"  class=\"gfield gfield--type-email field_sublabel_above gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_68\"><label class='gfield_label gform-field-label' for='input_6_68' >Administrative \/ Financial Manager&#039;s Email<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_68' id='input_6_68' type='text' value='' class='medium'     aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_6_30\"  class=\"gfield gfield--type-name gfield_contains_required field_sublabel_above gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_30\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Chairperson \/ Principal Investigator<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/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_6_30'>\n                            \n                            <span id='input_6_30_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_6_30_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_30.3' id='input_6_30_3' value=''   aria-required='true'     \/>\n                                                <\/span>\n                            \n                            <span id='input_6_30_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_6_30_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_30.6' id='input_6_30_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/li><li id=\"field_6_6\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_above gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_6\"><label class='gfield_label gform-field-label'  >Billing Information<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_6'>\n\t\t\t<li class='gchoice gchoice_6_6_0'>\n\t\t\t\t<input name='input_6' type='radio' value='BU Funds Center'  id='choice_6_6_0'    \/>\n\t\t\t\t<label for='choice_6_6_0' id='label_6_6_0' class='gform-field-label gform-field-label--type-inline'>BU Funds Center Number<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_6_1'>\n\t\t\t\t<input name='input_6' type='radio' value='BMC Account'  id='choice_6_6_1'    \/>\n\t\t\t\t<label for='choice_6_6_1' id='label_6_6_1' class='gform-field-label gform-field-label--type-inline'>BMC Account Number<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_6_2'>\n\t\t\t\t<input name='input_6' type='radio' value='Personal'  id='choice_6_6_2'    \/>\n\t\t\t\t<label for='choice_6_6_2' id='label_6_6_2' class='gform-field-label gform-field-label--type-inline'>Personal<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_37\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_above gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_37\"><label class='gfield_label gform-field-label' for='input_6_37' >BU Funds Center Number (10 digits)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_37' id='input_6_37' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_59\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_above gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_59\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Complete Billing Information<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_6_59'><li class='gchoice gchoice_6_59_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_59.1' type='checkbox'  value='By checking this box, you understand that we are unable to start your work request without payment. For personal payment, we accept cash or check.'  id='choice_6_59_1'   aria-describedby=\"gfield_description_6_59\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_6_59_1' id='label_6_59_1' class='gform-field-label gform-field-label--type-inline'>I Agree.<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_6_59'>By checking this box, you understand that we are unable to start your work request without complete and valid billing information. \nFor BU departments, this includes the 10-digit Funds Center number, AND an ISR number.<\/div><\/li><li id=\"field_6_61\"  class=\"gfield gfield--type-text field_sublabel_above gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_61\"><label class='gfield_label gform-field-label' for='input_6_61' >BU ISR Number (10 digits)<\/label><div class='ginput_container ginput_container_text'><input name='input_61' id='input_6_61' type='text' value='' class='medium'  aria-describedby=\"gfield_description_6_61\"    aria-invalid=\"false\"   \/> <\/div><div class='gfield_description' id='gfield_description_6_61'>Please visit BU Works <a href=\"https:\/\/ppo.buw.bu.edu\/\" target=\"_blank\"><B>https:\/\/ppo.buw.bu.edu\/<\/B><\/a> to start the process of creating an ISR (Use provider \"BUMC Production Services\").  If you cannot submit an ISR, please confer with your financial administrator or manager.<\/div><\/li><li id=\"field_6_45\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_above gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_45\"><label class='gfield_label gform-field-label' for='input_6_45' >BMC Account Number (7 Digits)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_45' id='input_6_45' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_60\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_above gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_60\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Complete Billing Information<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_6_60'><li class='gchoice gchoice_6_60_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_60.1' type='checkbox'  value='By checking this box, you understand that we are unable to start your work request without payment. For personal payment, we accept cash or check.'  id='choice_6_60_1'   aria-describedby=\"gfield_description_6_60\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_6_60_1' id='label_6_60_1' class='gform-field-label gform-field-label--type-inline'>I Agree.<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_6_60'>By checking this box, you understand that we are unable to start your work request without complete and valid billing information. \nFor BMC, this is the 7-digit account number and full billing address.<\/div><\/li><li id=\"field_6_9\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_above gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_9\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Complete Billing Information<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_6_9'><li class='gchoice gchoice_6_9_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.1' type='checkbox'  value='By checking this box, you understand that we are unable to start your work request without payment. For personal payment, we accept cash or check.'  id='choice_6_9_1'   aria-describedby=\"gfield_description_6_9\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_6_9_1' id='label_6_9_1' class='gform-field-label gform-field-label--type-inline'>I Agree.<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_6_9'>By checking this box, you understand that we are unable to start your work request without payment. <br \/>\nFor personal payment, we accept cash or check.<\/div><\/li><li id=\"field_6_20\"  class=\"gfield gfield--type-address gfield_contains_required field_sublabel_above gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_20\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Billing Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_6_20' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_6_20_1_container' >\n                                        <label for='input_6_20_1' id='input_6_20_1_label' class='gform-field-label gform-field-label--type-sub '>Building, Room No.<\/label>\n                                        <input type='text' name='input_20.1' id='input_6_20_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_6_20_2_container' >\n                                        <label for='input_6_20_2' id='input_6_20_2_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_20.2' id='input_6_20_2' value=''     aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_6_20_3_container' >\n                                    <label for='input_6_20_3' id='input_6_20_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_20.3' id='input_6_20_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_6_20_4_container' >\n                                        <label for='input_6_20_4' id='input_6_20_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                        <select name='input_20.4' id='input_6_20_4'     aria-required='true'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' selected='selected'>Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_6_20_5_container' >\n                                    <label for='input_6_20_5' id='input_6_20_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                    <input type='text' name='input_20.5' id='input_6_20_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_20.6' id='input_6_20_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_6_21\"  class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield_contains_required field_sublabel_above gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_21\"><label class='gfield_label gform-field-label' for='input_6_21' >Due Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_21' id='input_6_21' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_6_21_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_6_21_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_6_21' class='gform_hidden' value='https:\/\/www.bumc.bu.edu\/comm\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_6_22\"  class=\"gfield gfield--type-time field_sublabel_above gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_22\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Due Time<\/label><div class=\"ginput_container ginput_complex gform-grid-row\"><div class=\"clear-multi\">\n                        <div class='gfield_time_hour ginput_container ginput_container_time gform-grid-col' id='input_6_22'>\n                            <label class='gform-field-label gform-field-label--type-sub hour_label screen-reader-text' for='input_6_22_1'>Hours<\/label>\n                            <input type='text' maxlength='2' name='input_22[]' id='input_6_22_1' value='4'    placeholder='HH' aria-required='false'   aria-describedby=\"gfield_description_6_22\"\/> <i>:<\/i>\n                        <\/div>\n                        \n                        <div class='gfield_time_minute ginput_container ginput_container_time gform-grid-col'>\n                            <label class='gform-field-label gform-field-label--type-sub minute_label screen-reader-text' for='input_6_22_2'>Minutes<\/label>\n                            <input type='text' maxlength='2' name='input_22[]' id='input_6_22_2' value='30'    placeholder='MM' aria-required='false'  \/>\n                        <\/div>\n                        <div class='gfield_time_ampm ginput_container ginput_container_time below gform-grid-col' >\n                                <div class='gfield_time_ampm_shim' aria-hidden='true'>&nbsp;<\/div>\n                                <select name='input_22[]' id='input_6_22_3'  >\n                                    <option value='am' >AM<\/option>\n                                    <option value='pm' selected='selected'>PM<\/option>\n                                <\/select> \n                                <label class='gform-field-label gform-field-label--type-sub am_pm_label screen-reader-text' for='input_6_22_3'>AM\/PM<\/label>                                \n                           <\/div>\n                    <\/div><\/div><div class='gfield_description' id='gfield_description_6_22'>Work is completed by 4:30 pm unless specified otherwise.<\/div><\/li><li id=\"field_6_25\"  class=\"gfield gfield--type-hidden gform_hidden field_sublabel_above gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_25\"><div class='ginput_container ginput_container_text'><input name='input_25' id='input_6_25' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='216.73.216.59' \/><\/div><\/li><li id=\"field_6_19\"  class=\"gfield gfield--type-hidden gform_hidden field_sublabel_above gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_19\"><div class='ginput_container ginput_container_text'><input name='input_19' id='input_6_19' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='Hidden Field 07\/26\/2026' \/><\/div><\/li><li id=\"field_6_70\"  class=\"gfield gfield--type-section gsection bu_google_recaptcha_section field_sublabel_above gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_70\"><h2 class=\"gsection_title\"><\/h2><\/li><li id=\"field_6_71\"  class=\"gfield gfield--type-html bu_google_recaptcha gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_71\"><div class=\"g-recaptcha\" data-sitekey=\"6LeGxkEjAAAAAK4nzHZn3a_6jB2ELSN935WrVBfC\"><\/div><\/li><\/ul><\/div>\n        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_6' class='gform_button button' value='SUBMIT'  onclick='if(window[\"gf_submitting_6\"]){return false;}  window[\"gf_submitting_6\"]=true;  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} window[\"gf_submitting_6\"]=true;  jQuery(\"#gform_6\").trigger(\"submit\",[true]); }' \/> <a type='button' href=\"javascript:void(0);\" id='gform_save_6_footer_link' class='gform_save_link gform-theme-button gform-theme-button--secondary'  onclick='if(window[\"gf_submitting_6\"]){return false;}  window[\"gf_submitting_6\"]=true; jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]);' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} window[\"gf_submitting_6\"]=true; jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]); }'> Save and complete later. Please ensure that your internet connection is safe.<\/a>\n            <input type='hidden' class='gform_hidden' name='is_submit_6' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='6' \/>\n            <input type='hidden' class='gform_hidden' name='gform_save' id='gform_save_6' value='' \/>\n                             <input type='hidden' class='gform_hidden' name='gform_resume_token' id='gform_resume_token_6' value='' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_6' value='WyJbXSIsImQ5Y2U2OGUxNzE1OTZlYjZkN2E4MzI4YmJhNDVlODY3Il0=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_target_page_number_6' id='gform_target_page_number_6' value='0' \/>\n            <input type='hidden' class='gform_hidden' name='gform_source_page_number_6' id='gform_source_page_number_6' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            <input type='hidden' name='gform_uploaded_files' id='gform_uploaded_files_6' value='' \/>\n        <\/div>\n                        <\/form>\n                        <\/div><script type=\"text\/javascript\">\ngform.initializeOnLoaded( function() {gformInitSpinner( 6, 'https:\/\/www.bumc.bu.edu\/comm\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery('#gform_ajax_frame_6').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_6');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_6').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) + 100;if(is_form){jQuery('#gform_wrapper_6').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_6').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_6').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/  }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_6').val();gformInitSpinner( 6, 'https:\/\/www.bumc.bu.edu\/comm\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery(document).trigger('gform_page_loaded', [6, current_page]);window['gf_submitting_6'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}setTimeout(function(){jQuery('#gform_wrapper_6').replaceWith(confirmation_content);jQuery(document).trigger('gform_confirmation_loaded', [6]);window['gf_submitting_6'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_6').text());}, 50);}else{jQuery('#gform_6').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger('gform_post_render', [6, current_page]);gform.utils.trigger({ event: 'gform\/postRender', native: false, data: { formId: 6, currentPage: current_page } });} );} );\n<\/script>\n<br \/>\n<!-- comment --><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":900,"featured_media":0,"parent":1740,"menu_order":2,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/www.bumc.bu.edu\/comm\/wp-json\/wp\/v2\/pages\/1760"}],"collection":[{"href":"https:\/\/www.bumc.bu.edu\/comm\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.bumc.bu.edu\/comm\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/comm\/wp-json\/wp\/v2\/users\/900"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/comm\/wp-json\/wp\/v2\/comments?post=1760"}],"version-history":[{"count":10,"href":"https:\/\/www.bumc.bu.edu\/comm\/wp-json\/wp\/v2\/pages\/1760\/revisions"}],"predecessor-version":[{"id":1782,"href":"https:\/\/www.bumc.bu.edu\/comm\/wp-json\/wp\/v2\/pages\/1760\/revisions\/1782"}],"up":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/comm\/wp-json\/wp\/v2\/pages\/1740"}],"wp:attachment":[{"href":"https:\/\/www.bumc.bu.edu\/comm\/wp-json\/wp\/v2\/media?parent=1760"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}