{"id":4770,"date":"2022-05-31T10:20:30","date_gmt":"2022-05-31T14:20:30","guid":{"rendered":"https:\/\/health.uconn.edu\/health-disparities\/?page_id=4770"},"modified":"2022-05-31T10:20:30","modified_gmt":"2022-05-31T14:20:30","slug":"ideas-lab-intent-to-pitch-form","status":"publish","type":"page","link":"https:\/\/health.uconn.edu\/health-disparities\/ideas-lab-intent-to-pitch-form\/","title":{"rendered":"IDEAS Lab: Intent to Pitch Form"},"content":{"rendered":"<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_30' style='display:none'><div id='gf_30' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data'  id='gform_30'  action='\/health-disparities\/wp-json\/wp\/v2\/pages\/4770#gf_30' data-formid='30' novalidate>\n        <div id='gf_progressbar_wrapper_30' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>3<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_33' style='width:33%;'><span>33%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_30_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_30' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_30_24\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_24'><span class='gform-field-label__text'>Facebook<\/span><\/label><div class='ginput_container'><input name='input_24' id='input_30_24' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_30_24'>This field is for validation purposes and should be left unchanged.<\/div><\/div><fieldset id=\"field_30_1\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Check Your Eligibility:  Before beginning the application process, you must make sure you or your organization is eligible to apply for the grant.   Please select all that apply.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_30_1'><div class='gchoice gchoice_30_1_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_1.1' type='checkbox'  value='Our team will present at the pitch event in August 2022. Dates will be provided to teams who intend to pitch.'  id='choice_30_1_1'   aria-describedby=\"gfield_description_30_1\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_30_1_1' id='label_30_1_1' class='gform-field-label gform-field-label--type-inline'>Our team will present at the pitch event in August 2022. Dates will be provided to teams who intend to pitch.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_30_1'>\n\n<\/div><\/fieldset><fieldset id=\"field_30_20\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label screen-reader-text gfield_label_before_complex' ><span class='gform-field-label__text'><\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_30_20'><div class='gchoice gchoice_30_20_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.1' type='checkbox'  value='Our team has at least two members, inclusive of a community organization or partner.'  id='choice_30_20_1'   aria-describedby=\"gfield_description_30_20\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_30_20_1' id='label_30_20_1' class='gform-field-label gform-field-label--type-inline'>Our team has at least two members, inclusive of a community organization or partner.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_30_20'>\n\n<\/div><\/fieldset><fieldset id=\"field_30_23\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label screen-reader-text gfield_label_before_complex' ><span class='gform-field-label__text'><\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_30_23'><div class='gchoice gchoice_30_23_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.1' type='checkbox'  value='Our team has a UConn Principal Investigator\/Project Director.'  id='choice_30_23_1'   aria-describedby=\"gfield_description_30_23\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_30_23_1' id='label_30_23_1' class='gform-field-label gform-field-label--type-inline'>Our team has a UConn Principal Investigator\/Project Director.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_30_23'>\n\n<\/div><\/fieldset><fieldset id=\"field_30_22\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label screen-reader-text gfield_label_before_complex' ><span class='gform-field-label__text'><\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_30_22'><div class='gchoice gchoice_30_22_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.1' type='checkbox'  value='Our team represents at least two different disciplines or sectors.'  id='choice_30_22_1'   aria-describedby=\"gfield_description_30_22\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_30_22_1' id='label_30_22_1' class='gform-field-label gform-field-label--type-inline'>Our team represents at least two different disciplines or sectors.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_30_22'>\n\n<\/div><\/fieldset><fieldset id=\"field_30_21\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label screen-reader-text gfield_label_before_complex' ><span class='gform-field-label__text'><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_30_21'><div class='gchoice gchoice_30_21_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.1' type='checkbox'  value='Optional:  Our team has intergenerational representation.'  id='choice_30_21_1'   aria-describedby=\"gfield_description_30_21\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_30_21_1' id='label_30_21_1' class='gform-field-label gform-field-label--type-inline'>Optional:  Our team has intergenerational representation.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_30_21'>\n\n<\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <button type='button' id='gform_next_button_30_10' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_30_2' class='gform_page' data-js='page-field-id-10' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_30_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_30_14\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Team Information<\/h3><\/div><div id=\"field_30_2\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_2'><span class='gform-field-label__text'>Pitch Title or Team Name:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text' data-text-counter-max='250' data-text-counter-template='{current} of {max} max characters'><input name='input_2' id='input_30_2' type='text' value='' class='large' maxlength='250'    aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_30_4\" class=\"gfield gfield--type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Team Contact Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name has_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_3 ginput_container_name gform-grid-row' id='input_30_4'>\n                            <span id='input_30_4_2_container' class='name_prefix name_prefix_select gform-grid-col gform-grid-col--size-auto' >\n                                                    <select name='input_4.2' id='input_30_4_2'    aria-required='false'   >\n                          <option value=''><\/option><option value='Dr.' >Dr.<\/option><option value='Miss' >Miss<\/option><option value='Mr.' >Mr.<\/option><option value='Mrs.' >Mrs.<\/option><option value='Ms.' >Ms.<\/option><option value='Prof.' >Prof.<\/option><option value='Rev.' >Rev.<\/option>\n                      <\/select>\n                                                    <label for='input_30_4_2' class='gform-field-label gform-field-label--type-sub '>Prefix<\/label>\n                                                  <\/span>\n                            <span id='input_30_4_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_4.3' id='input_30_4_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_30_4_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_30_4_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_4.6' id='input_30_4_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_30_4_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_30_5\" class=\"gfield gfield--type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_5'><span class='gform-field-label__text'>Team Contact Email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_5' id='input_30_5' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_30_6\" class=\"gfield gfield--type-phone gfield--phone-format-standard gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_6'><span class='gform-field-label__text'>Team Contact Phone Number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_6' id='input_30_6' type='tel' value='' class='large'  placeholder='(999) 999-9999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_30_13' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Previous<\/button> <button type='button' id='gform_next_button_30_13' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_30_3' class='gform_page' data-js='page-field-id-13' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_30_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_30_15\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Project Description<\/h3><\/div><fieldset id=\"field_30_7\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Which best describes your project pitch type? Please select the choice you think fits your pitch best<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_7'>\n\t\t\t<div class='gchoice gchoice_30_7_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='Practice'  id='choice_30_7_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_7_0' id='label_30_7_0' class='gform-field-label gform-field-label--type-inline'>Practice<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_30_7_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='Policy'  id='choice_30_7_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_7_1' id='label_30_7_1' class='gform-field-label gform-field-label--type-inline'>Policy<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_30_7_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='Community-based research'  id='choice_30_7_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_7_2' id='label_30_7_2' class='gform-field-label gform-field-label--type-inline'>Community-based research<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_30_8\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>What focus area(s) does your pitch cover? Select all that apply.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_30_8'><div class='gchoice gchoice_30_8_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_8.1' type='checkbox'  value='Behavioral health'  id='choice_30_8_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_8_1' id='label_30_8_1' class='gform-field-label gform-field-label--type-inline'>Behavioral health<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_30_8_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_8.2' type='checkbox'  value='Incarceration &amp; justice'  id='choice_30_8_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_8_2' id='label_30_8_2' class='gform-field-label gform-field-label--type-inline'>Incarceration &amp; justice<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_30_8_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_8.3' type='checkbox'  value='HIV\/AIDs'  id='choice_30_8_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_8_3' id='label_30_8_3' class='gform-field-label gform-field-label--type-inline'>HIV\/AIDs<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_30_8_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_8.4' type='checkbox'  value='Trauma'  id='choice_30_8_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_8_4' id='label_30_8_4' class='gform-field-label gform-field-label--type-inline'>Trauma<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_30_8_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_8.5' type='checkbox'  value='Other:  please specify'  id='choice_30_8_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_8_5' id='label_30_8_5' class='gform-field-label gform-field-label--type-inline'>Other:  please specify<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_30_12\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_12'><span class='gform-field-label__text'>Other focus area<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_30_12' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_30_16\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_16'><span class='gform-field-label__text'>What sector(s) does your team represent (e.g., healthcare, education, social services, etc.)?  Please list all that apply.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_30_16' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_30_17\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_17'><span class='gform-field-label__text'>Write one sentence that describes the big idea about health equity among boys and men of color that your team wants to spread.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input 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