{"id":2988,"date":"2021-08-03T10:53:08","date_gmt":"2021-08-03T14:53:08","guid":{"rendered":"https:\/\/alix.interligne.co\/report-a-situation-of-violence\/"},"modified":"2021-08-11T14:08:37","modified_gmt":"2021-08-11T18:08:37","slug":"report-a-situation-of-violence","status":"publish","type":"page","link":"https:\/\/alix.interligne.co\/en\/report-a-situation-of-violence\/","title":{"rendered":"Report a situation of violence"},"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 InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return 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_2' style='display:none'><div id='gf_2' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Have  you witnessed violence or abuse?<\/h2>\n                            <p class='gform_description'>Any question marked with a (*) is mandatory.<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_2'  action='\/en\/wp-json\/wp\/v2\/pages\/2988#gf_2' data-formid='2' novalidate><div id='gf_page_steps_2' class='gf_page_steps'><div id='gf_step_2_1' class='gf_step gf_step_active gf_step_first'><span class='gf_step_number'>1<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_2_2' class='gf_step gf_step_next gf_step_pending'><span class='gf_step_number'>2<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_2_3' class='gf_step gf_step_pending'><span class='gf_step_number'>3<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_2_4' class='gf_step gf_step_pending'><span class='gf_step_number'>4<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_2_5' class='gf_step gf_step_pending'><span class='gf_step_number'>5<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_2_6' class='gf_step gf_step_pending'><span class='gf_step_number'>6<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_2_7' class='gf_step gf_step_last gf_step_pending'><span class='gf_step_number'>7<\/span><span class='gf_step_label'><\/span><\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_2_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_2' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_2_1\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">1. YOUR SOCIO-DEMOGRAPHIC INFORMATION <\/h3><\/div><div id=\"field_2_2\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">How old are you?*<\/h3><\/div><div id=\"field_2_17\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_17'>1T &#8211; \u00c2ge<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_17' id='input_2_17' type='number' step='any' min='0'  value='' class='large'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_2_17\" \/><div class='gfield_description instruction ' id='gfield_instruction_2_17'>Please enter a number greater than or equal to <strong>0<\/strong>.<\/div><\/div><\/div><fieldset id=\"field_2_18\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >1T &#8211; \u00c2ge<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_18'><div class='gchoice gchoice_2_18_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.1' type='checkbox'  value='Je pr\u00e9f\u00e8re ne pas r\u00e9pondre'  id='choice_2_18_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_18_1' id='label_2_18_1' class='gform-field-label gform-field-label--type-inline'>I prefer not to answer<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_4\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Where do you live now?  <\/h3><div class='gsection_description' id='gfield_description_2_4'>This information will only be used for statistical purposes and your identity will remain anonymous.<\/div><\/div><div id=\"field_2_11\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Country*<\/h3><\/div><div id=\"field_2_5\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_5'>1T &#8211; Pays<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_5' id='input_2_5' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Afrique du Sud' >South Africa<\/option><option value='Albanie' >Albania<\/option><option value='Alg\u00e9rie' >Alg\u00e9rie<\/option><option value='Allemagne' >Germany<\/option><option value='Andorre' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Antigua-et-Barbuda' >Antigua and Barbuda<\/option><option value='Arabie Saoudite' >Saudi Arabia<\/option><option value='Argentine' >Argentina<\/option><option value='Arm\u00e9nie' >Armenia<\/option><option value='Australie' >Australia<\/option><option value='Autriche' >Austria<\/option><option value='Azerba\u00efdjan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahre\u00efn' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbade' >Barbados<\/option><option value='Bi\u00e9lorussie' >Belarus<\/option><option value='Belgique' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='B\u00e9nin' >Benin<\/option><option value='Bhoutan' >Bhutan<\/option><option value='Bolivie' >Bolivia<\/option><option value='Bosnie-Herz\u00e9govine' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Brunei' >Brunei<\/option><option value='Br\u00e9sil' >Brazil<\/option><option value='Bulgarie' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cambodge' >Cambodia<\/option><option value='Cameroun' >Cameroon<\/option><option value='Canada' selected='selected'>Canada<\/option><option value='Cap-Vert' >Cabo Verde<\/option><option value='Chili' >Chile<\/option><option value='Chine' >China<\/option><option value='Chypre' >Cyprus<\/option><option value='Colombie' >Colombia<\/option><option value='Comores' >Comoros<\/option><option value='Cor\u00e9e du Nord' >North Korea<\/option><option value='Cor\u00e9e du Sud' >South Korea<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatie' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cote d&#039;Ivoire' >Cote d&#039;Ivoire<\/option><option value='Danemark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominique' >Dominica<\/option><option value='\u00c9gypte' >Egypt<\/option><option value='\u00c9mirats arabes unis' >United Arab Emirates<\/option><option value='\u00c9quateur' >Ecuador<\/option><option value='\u00c9rythr\u00e9e' >Eritrea<\/option><option value='Espagne' >Spain<\/option><option value='Estonie' >Estonia<\/option><option value='Eswatini (Swaziland)' >Eswatini (Swaziland)<\/option><option value='\u00c9tats-Unis' >United States<\/option><option value='\u00c9thiopie' >Ethiopia<\/option><option value='Fidji' >Fiji<\/option><option value='Finlande' >Finland<\/option><option value='France' >France<\/option><option value='Gabon' >Gabon<\/option><option value='Gambie' >Gambia<\/option><option value='G\u00e9orgie' >Georgia<\/option><option value='Ghana' >Ghana<\/option><option value='Grenade' >Grenada<\/option><option value='Gr\u00e8ce' >Greece<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guin\u00e9e' >Guinea<\/option><option value='Guin\u00e9e \u00e9quatoriale' >Equatorial Guinea<\/option><option value='Guin\u00e9e-Bissau' >Guinea-Bissau<\/option><option value='Guyane' >Guyana<\/option><option value='Ha\u00efti' >Haiti<\/option><option value='Honduras' >Honduras<\/option><option value='Hongrie' >Hungary<\/option><option value='\u00celes Cook' >Cook Islands<\/option><option value='\u00celes Marshall' >Marshall Islands<\/option><option value='\u00celes Salomon' >Solomon Islands<\/option><option value='Inde' >India<\/option><option value='Indon\u00e9sie' >Indonesia<\/option><option value='Irak' >Iraq<\/option><option value='Iran' >Iran<\/option><option value='Irlande' >Ireland<\/option><option value='Islande' >Iceland<\/option><option value='Isra\u00ebl' >Israel<\/option><option value='Italie' >Italy<\/option><option value='Jama\u00efque' >Jamaica<\/option><option value='Japon' >Japan<\/option><option value='Jordanie' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kirghizistan' >Kyrgyzstan<\/option><option value='Kiribati' >Kiribati<\/option><option value='Kosovo' >Kosovo<\/option><option value='Kowe\u00eft' >Kuwait<\/option><option value='Lesotho' >Lesotho<\/option><option value='Lettonie' >Latvia<\/option><option value='Liban' >Lebanon<\/option><option value='Liberia' >Liberia<\/option><option value='Libye' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lituanie' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malaisie' >Malaysia<\/option><option value='Malawi' >Malawi<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malte' >Malta<\/option><option value='Maroc' >Morocco<\/option><option value='Maurice' >Mauritius<\/option><option value='Mauritanie' >Mauritania<\/option><option value='Mexique' >Mexico<\/option><option value='Micron\u00e9sie' >Micronesia<\/option><option value='Moldavie' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolie' >Mongolia<\/option><option value='Mont\u00e9n\u00e9gro' >Montenegro<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibie' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nig\u00e9ria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norv\u00e8ge' >Norway<\/option><option value='Nouvelle-Z\u00e9lande' >New Zealand<\/option><option value='N\u00e9pal' >Nepal<\/option><option value='Oman' >Oman<\/option><option value='Ouganda' >Ouganda<\/option><option value='Ouzb\u00e9kistan' >Uzbekistan<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine' >Palestine<\/option><option value='Panama' >Panama<\/option><option value='Papouasie-Nouvelle-Guin\u00e9e' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Pays-Bas' >Netherlands<\/option><option value='Philippines' >Philippines<\/option><option value='Pologne' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='P\u00e9rou' >Peru<\/option><option value='Qatar' >Qatar<\/option><option value='R\u00e9publique Dominicaine' >Dominican Republic<\/option><option value='R\u00e9publique centrafricaine' >Central African Republic<\/option><option value='R\u00e9publique du Congo' >Congo, Republic of the<\/option><option value='R\u00e9publique d\u00e9mocratique du Congo' >Congo, Democratic Republic of<\/option><option value='R\u00e9publique d\u00e9mocratique populaire du Laos' >Laos<\/option><option value='Roumanie' >Romania<\/option><option value='Royaume-Uni' >United Kingdom<\/option><option value='Russie' >Russia<\/option><option value='Rwanda' >Rwanda<\/option><option value='Saint-Christophe-et-Nevis' >Saint Kitts and Nevis<\/option><option value='Saint-Marin' >Saint Marin<\/option><option value='Saint-Vincent-et-les Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Sainte-Lucie' >Saint Lucia<\/option><option value='Salvador' >El Salvador<\/option><option value='Samoa' >Samoa<\/option><option value='Sao Tom\u00e9 et Principe' >Sao Tome and Principe<\/option><option value='Serbie' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapour' >Singapore<\/option><option value='Slovaquie' >Slovakia<\/option><option value='Slov\u00e9nie' >Slovenia<\/option><option value='Somalie' >Somalia<\/option><option value='Soudan' >Sudan<\/option><option value='Soudan du Sud' >Sudan, South<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Suisse' >Switzerland<\/option><option value='Suriname' >Suriname<\/option><option value='Su\u00e8de' >Sweden<\/option><option value='Syrie' >Syria<\/option><option value='S\u00e9n\u00e9gal' >Senegal<\/option><option value='Ta\u00efwan' >Taiwan<\/option><option value='Tadjikistan' >Tadjikistan<\/option><option value='Tanzanie' >Tanzania<\/option><option value='Tchad' >Chad<\/option><option value='Tch\u00e9quie' >Czechia<\/option><option value='Tha\u00eflande' >Thailand<\/option><option value='Timor oriental' >East Timor (Timor-Leste)<\/option><option value='Togo' >Togo<\/option><option value='Tonga' >Tonga<\/option><option value='Trinit\u00e9 et Tobago' >Trinidad and Tobago<\/option><option value='Tunisie' >Tunisia<\/option><option value='Turkm\u00e9nistan' >Turmekistan<\/option><option value='Turquie' >Turkey<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='Ukraine' >Ukraine<\/option><option value='Uruguay' >Uruguay<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Vatican' >Vatican City<\/option><option value='Venezuela' >Venezuela<\/option><option value='Vietnam' >Vietnam<\/option><option value='Y\u00e9men' >Yemen<\/option><option value='Zambie' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><\/select><\/div><\/div><fieldset id=\"field_2_6\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >1T &#8211; Pays<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_6'><div class='gchoice gchoice_2_6_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_6.1' type='checkbox'  value='Je pr\u00e9f\u00e8re ne pas r\u00e9pondre'  id='choice_2_6_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_6_1' id='label_2_6_1' class='gform-field-label gform-field-label--type-inline'>I prefer not to answer<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_12\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Province or territory<\/h3><\/div><div id=\"field_2_7\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_7'>1T &#8211; Province ou territoire<\/label><div class='ginput_container ginput_container_select'><select name='input_7' id='input_2_7' class='large gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Alberta' >Alberta<\/option><option value='Colombie-Britannique' >British Columbia<\/option><option value='Manitoba' >Manitoba<\/option><option value='Nouveau-Brunswick' >New Brunswick<\/option><option value='Terre-Neuve-et-Labrador' >Newfoundland and Labrador<\/option><option value='Territoires du Nord-Ouest' >Northwest Territories<\/option><option value='Nouvelle-\u00c9cosse' >Nova Scotia<\/option><option value='Nunavut' >Nunavut<\/option><option value='Ontario' >Ontario<\/option><option value='\u00cele du Prince-\u00c9douard' >Prince Edward Island<\/option><option value='Qu\u00e9bec' >Quebec<\/option><option value='Saskatchewan' >Saskatchewan<\/option><option value='Yukon' >Yukon<\/option><\/select><\/div><\/div><fieldset id=\"field_2_8\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >1T &#8211; Province ou territoire<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_8'><div class='gchoice gchoice_2_8_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_8.1' type='checkbox'  value='Je pr\u00e9f\u00e8re ne pas r\u00e9pondre'  id='choice_2_8_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_8_1' id='label_2_8_1' class='gform-field-label gform-field-label--type-inline'>I prefer not to answer<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_13\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">City or town<\/h3><\/div><div id=\"field_2_9\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_9'>1T &#8211; Ville ou village<\/label><div class='ginput_container ginput_container_select'><select name='input_9' id='input_2_9' class='large gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Abercorn' >Abercorn<\/option><option value='Abitibi' >Abitibi<\/option><option value='Abitibi-Ouest' >Abitibi-Ouest<\/option><option value='Acton' >Acton<\/option><option value='Acton Vale' >Acton Vale<\/option><option value='Adstock' >Adstock<\/option><option value='Aguanish' >Aguanish<\/option><option value='Akulivik' >Akulivik<\/option><option value='Albanel' >Albanel<\/option><option value='Albertville' >Albertville<\/option><option value='Alleyn-et-Cawood' >Alleyn-et-Cawood<\/option><option value='Alma' >Alma<\/option><option value='Amherst' >Amherst<\/option><option value='Amos' >Amos<\/option><option value='Amqui' >Amqui<\/option><option value='Ange-Gardien' >Ange-Gardien<\/option><option value='Antoine-Labelle' >Antoine-Labelle<\/option><option value='Argenteuil' >Argenteuil<\/option><option value='Armagh' >Armagh<\/option><option value='Arthabaska' >Arthabaska<\/option><option value='Arundel' >Arundel<\/option><option value='Asbestos' >Asbestos<\/option><option value='Ascot Corner' >Ascot Corner<\/option><option value='Aston-Jonction' >Aston-Jonction<\/option><option value='Auclair' >Auclair<\/option><option value='Audet' >Audet<\/option><option value='Aumond' >Aumond<\/option><option value='Aupaluk' >Aupaluk<\/option><option value='Austin' >Austin<\/option><option value='Authier' >Authier<\/option><option value='Authier-Nord' >Authier-Nord<\/option><option value='Avignon' >Avignon<\/option><option value='Ayer&#039;s Cliff' >Ayer&#039;s Cliff<\/option><option value='Baie-Comeau' >Baie-Comeau<\/option><option value='Baie-D&#039;Urf\u00e9' >Baie-D&#039;Urf\u00e9<\/option><option value='Baie-Johan-Beetz' >Baie-Johan-Beetz<\/option><option value='Baie-Saint-Paul' >Baie-Saint-Paul<\/option><option value='Baie-Sainte-Catherine' >Baie-Sainte-Catherine<\/option><option value='Baie-Trinit\u00e9' >Baie-Trinit\u00e9<\/option><option value='Baie-des-Sables' >Baie-des-Sables<\/option><option value='Baie-du-Febvre' >Baie-du-Febvre<\/option><option value='Barkmere' >Barkmere<\/option><option value='Barnston-Ouest' >Barnston-Ouest<\/option><option value='Barraute' >Barraute<\/option><option value='Batiscan' >Batiscan<\/option><option value='Batiscan' >Batiscan<\/option><option value='B\u00e9arn' >B\u00e9arn<\/option><option value='Beauce-Sartigan' >Beauce-Sartigan<\/option><option value='Beauceville' >Beauceville<\/option><option value='Beauharnois' >Beauharnois<\/option><option value='Beauharnois-Salaberry' >Beauharnois-Salaberry<\/option><option value='Beaulac-Garthby' >Beaulac-Garthby<\/option><option value='Beaumont' >Beaumont<\/option><option value='Beaupr\u00e9' >Beaupr\u00e9<\/option><option value='B\u00e9cancour' >B\u00e9cancour<\/option><option value='Bedford' >Bedford<\/option><option value='B\u00e9gin' >B\u00e9gin<\/option><option value='Belcourt' >Belcourt<\/option><option value='Bellechasse' >Bellechasse<\/option><option value='Belleterre' >Belleterre<\/option><option value='Beloeil' >Beloeil<\/option><option value='Berry' >Berry<\/option><option value='Berthier-sur-Mer' >Berthier-sur-Mer<\/option><option value='Berthierville' >Berthierville<\/option><option value='B\u00e9thanie' >B\u00e9thanie<\/option><option value='Biencourt' >Biencourt<\/option><option value='Blainville' >Blainville<\/option><option value='Blanc-Sablon' >Blanc-Sablon<\/option><option value='Blue Sea' >Blue Sea<\/option><option value='Boileau' >Boileau<\/option><option value='Bois-Franc' >Bois-Franc<\/option><option value='Bois-des-Filion' >Bois-des-Filion<\/option><option value='Boisbriand' >Boisbriand<\/option><option value='Boischatel' >Boischatel<\/option><option value='Bolton-Est' >Bolton-Est<\/option><option value='Bolton-Ouest' >Bolton-Ouest<\/option><option value='Bonaventure' >Bonaventure<\/option><option value='Bonne-Esp\u00e9rance' >Bonne-Esp\u00e9rance<\/option><option value='Bonsecours' >Bonsecours<\/option><option value='Boucherville' >Boucherville<\/option><option value='Bouchette' >Bouchette<\/option><option value='Bowman' >Bowman<\/option><option value='Br\u00e9beuf' >Br\u00e9beuf<\/option><option value='Brigham' >Brigham<\/option><option value='Bristol' >Bristol<\/option><option value='Brome' >Brome<\/option><option value='Brome-Missisquoi' >Brome-Missisquoi<\/option><option value='Bromont' >Bromont<\/option><option value='Brossard' >Brossard<\/option><option value='Brownsburg-Chatham' >Brownsburg-Chatham<\/option><option value='Bryson' >Bryson<\/option><option value='Bury' >Bury<\/option><option value='Cacouna' >Cacouna<\/option><option value='Calixa-Lavall\u00e9e' >Calixa-Lavall\u00e9e<\/option><option value='Campbell&#039;s Bay' >Campbell&#039;s Bay<\/option><option value='Candiac' >Candiac<\/option><option value='Caniapiscau' >Caniapiscau<\/option><option value='Cantley' >Cantley<\/option><option value='Cap-Chat' >Cap-Chat<\/option><option value='Cap-Saint-Ignace' >Cap-Saint-Ignace<\/option><option value='Cap-Sant\u00e9' >Cap-Sant\u00e9<\/option><option value='Caplan' >Caplan<\/option><option value='Carignan' >Carignan<\/option><option value='Carleton-sur-Mer' >Carleton-sur-Mer<\/option><option value='Cascap\u00e9dia--Saint-Jules' >Cascap\u00e9dia&#8211;Saint-Jules<\/option><option value='Causapscal' >Causapscal<\/option><option value='Cayamant' >Cayamant<\/option><option value='Chambly' >Chambly<\/option><option value='Chambord' >Chambord<\/option><option value='Champlain' >Champlain<\/option><option value='Champneuf' >Champneuf<\/option><option value='Chandler' >Chandler<\/option><option value='Chapais' >Chapais<\/option><option value='Charette' >Charette<\/option><option value='Charlemagne' >Charlemagne<\/option><option value='Charlevoix' >Charlevoix<\/option><option value='Charlevoix-Est' >Charlevoix-Est<\/option><option value='Chartierville' >Chartierville<\/option><option value='Ch\u00e2teau-Richer' >Ch\u00e2teau-Richer<\/option><option value='Ch\u00e2teauguay' >Ch\u00e2teauguay<\/option><option value='Chazel' >Chazel<\/option><option value='Chelsea' >Chelsea<\/option><option value='Ch\u00e9n\u00e9ville' >Ch\u00e9n\u00e9ville<\/option><option value='Chertsey' >Chertsey<\/option><option value='Chesterville' >Chesterville<\/option><option value='Chibougamau' >Chibougamau<\/option><option value='Chichester' >Chichester<\/option><option value='Chisasibi' >Chisasibi<\/option><option value='Chute-Saint-Philippe' >Chute-Saint-Philippe<\/option><option value='Chute-aux-Outardes' >Chute-aux-Outardes<\/option><option value='Clarendon' >Clarendon<\/option><option value='Clermont' >Clermont<\/option><option value='Clerval' >Clerval<\/option><option value='Cleveland' >Cleveland<\/option><option value='Cloridorme' >Cloridorme<\/option><option value='Coaticook' >Coaticook<\/option><option value='Colombier' >Colombier<\/option><option value='Compton' >Compton<\/option><option value='Contrec\u0153ur' >Contrec\u0153ur<\/option><option value='Cookshire-Eaton' >Cookshire-Eaton<\/option><option value='C\u00f4te-Nord-du-Golfe-du-Saint-Laurent' >C\u00f4te-Nord-du-Golfe-du-Saint-Laurent<\/option><option value='C\u00f4te-Saint-Luc' >C\u00f4te-Saint-Luc<\/option><option value='Coteau-du-Lac' >Coteau-du-Lac<\/option><option value='Courcelles' >Courcelles<\/option><option value='Cowansville' >Cowansville<\/option><option value='Crabtree' >Crabtree<\/option><option value='D&#039;Autray' >D&#039;Autray<\/option><option value='Danville' >Danville<\/option><option value='Daveluyville' >Daveluyville<\/option><option value='D\u00e9gelis' >D\u00e9gelis<\/option><option value='D\u00e9l\u00e9age' >D\u00e9l\u00e9age<\/option><option value='Delson' >Delson<\/option><option value='Denholm' >Denholm<\/option><option value='Desbiens' >Desbiens<\/option><option value='Deschaillons-sur-Saint-Laurent' >Deschaillons-sur-Saint-Laurent<\/option><option value='Deschambault-Grondines' >Deschambault-Grondines<\/option><option value='Deux-Montagnes' >Deux-Montagnes<\/option><option value='Disraeli' >Disraeli<\/option><option value='Dixville' >Dixville<\/option><option value='Dolbeau-Mistassini' >Dolbeau-Mistassini<\/option><option value='Dollard-Des Ormeaux' >Dollard-Des Ormeaux<\/option><option value='Donnacona' >Donnacona<\/option><option value='Dorval' >Dorval<\/option><option value='Dosquet' >Dosquet<\/option><option value='Drummond' >Drummond<\/option><option value='Drummondville' >Drummondville<\/option><option value='Dudswell' >Dudswell<\/option><option value='Duhamel' >Duhamel<\/option><option value='Duhamel-Ouest' >Duhamel-Ouest<\/option><option value='Dundee' >Dundee<\/option><option value='Dunham' >Dunham<\/option><option value='Duparquet' >Duparquet<\/option><option value='Dupuy' >Dupuy<\/option><option value='Durham-Sud' >Durham-Sud<\/option><option value='East Angus' >East Angus<\/option><option value='East Broughton' >East Broughton<\/option><option value='East Farnham' >East Farnham<\/option><option value='East Hereford' >East Hereford<\/option><option value='Eastmain' >Eastmain<\/option><option value='Eastman' >Eastman<\/option><option value='Eeyou-Istchee Baie-James' >Eeyou-Istchee Baie-James<\/option><option value='Egan-Sud' >Egan-Sud<\/option><option value='Elgin' >Elgin<\/option><option value='Entrelacs' >Entrelacs<\/option><option value='Escuminac' >Escuminac<\/option><option value='Esprit-Saint' >Esprit-Saint<\/option><option value='Est\u00e9rel' >Est\u00e9rel<\/option><option value='Farnham' >Farnham<\/option><option value='Fassett' >Fassett<\/option><option value='Ferland-et-Boilleau' >Ferland-et-Boilleau<\/option><option value='Ferme-Neuve' >Ferme-Neuve<\/option><option value='Fermont' >Fermont<\/option><option value='Forestville' >Forestville<\/option><option value='Fort-Coulonge' >Fort-Coulonge<\/option><option value='Fortierville' >Fortierville<\/option><option value='Fossambault-sur-le-Lac' >Fossambault-sur-le-Lac<\/option><option value='Frampton' >Frampton<\/option><option value='Franklin' >Franklin<\/option><option value='Franquelin' >Franquelin<\/option><option value='Frelighsburg' >Frelighsburg<\/option><option value='Frontenac' >Frontenac<\/option><option value='Fug\u00e8reville' >Fug\u00e8reville<\/option><option value='Gallichan' >Gallichan<\/option><option value='Gasp\u00e9' >Gasp\u00e9<\/option><option value='Gatineau' >Gatineau<\/option><option value='Girardville' >Girardville<\/option><option value='Godbout' >Godbout<\/option><option value='Godmanchester' >Godmanchester<\/option><option value='Gore' >Gore<\/option><option value='Gracefield' >Gracefield<\/option><option value='Granby' >Granby<\/option><option value='Grand-M\u00e9tis' >Grand-M\u00e9tis<\/option><option value='Grand-Remous' >Grand-Remous<\/option><option value='Grand-Saint-Esprit' >Grand-Saint-Esprit<\/option><option value='Grande-Rivi\u00e8re' >Grande-Rivi\u00e8re<\/option><option value='Grande-Vall\u00e9e' >Grande-Vall\u00e9e<\/option><option value='Grandes-Piles' >Grandes-Piles<\/option><option value='Grenville' >Grenville<\/option><option value='Grenville-sur-la-Rouge' >Grenville-sur-la-Rouge<\/option><option value='Gros-M\u00e9catina' >Gros-M\u00e9catina<\/option><option value='Grosse-\u00cele' >Grosse-\u00cele<\/option><option value='Grosses-Roches' >Grosses-Roches<\/option><option value='Gu\u00e9rin' >Gu\u00e9rin<\/option><option value='Ham Sud' >Ham Sud<\/option><option value='Ham-Nord' >Ham-Nord<\/option><option value='Hampden' >Hampden<\/option><option value='Hampstead' >Hampstead<\/option><option value='Harrington' >Harrington<\/option><option value='Hatley' >Hatley<\/option><option value='Havelock' >Havelock<\/option><option value='Havre-Saint-Pierre' >Havre-Saint-Pierre<\/option><option value='H\u00e9bertville' >H\u00e9bertville<\/option><option value='H\u00e9bertville-Station' >H\u00e9bertville-Station<\/option><option value='Hemmingford' >Hemmingford<\/option><option value='Henryville' >Henryville<\/option><option value='H\u00e9rouxville' >H\u00e9rouxville<\/option><option value='Hinchinbrooke' >Hinchinbrooke<\/option><option value='Honfleur' >Honfleur<\/option><option value='Hope' >Hope<\/option><option value='Hope Town' >Hope Town<\/option><option value='Howick' >Howick<\/option><option value='Huberdeau' >Huberdeau<\/option><option value='Hudson' >Hudson<\/option><option value='Huntingdon' >Huntingdon<\/option><option value='Inukjuak' >Inukjuak<\/option><option value='Inverness' >Inverness<\/option><option value='Irlande' >Irlande<\/option><option value='Ivry-sur-le-Lac' >Ivry-sur-le-Lac<\/option><option value='Ivujivik' >Ivujivik<\/option><option value='Joliette' >Joliette<\/option><option value='Kamouraska' >Kamouraska<\/option><option value='Kangiqsualujjuaq' >Kangiqsualujjuaq<\/option><option value='Kangiqsujuaq' >Kangiqsujuaq<\/option><option value='Kangirsuk' >Kangirsuk<\/option><option value='Kawawachikamach' >Kawawachikamach<\/option><option value='Kazabazua' >Kazabazua<\/option><option value='Kiamika' >Kiamika<\/option><option value='Kingsbury' >Kingsbury<\/option><option value='Kingsey Falls' >Kingsey Falls<\/option><option value='Kinnear&#039;s Mills' >Kinnear&#039;s Mills<\/option><option value='Kipawa' >Kipawa<\/option><option value='Kirkland' >Kirkland<\/option><option value='Kuujjuaq' >Kuujjuaq<\/option><option value='Kuujjuarapik' >Kuujjuarapik<\/option><option value='L&#039;Ancienne-Lorette' >L&#039;Ancienne-Lorette<\/option><option value='L&#039;Ange-Gardien' >L&#039;Ange-Gardien<\/option><option value='L&#039;Anse-Saint-Jean' >L&#039;Anse-Saint-Jean<\/option><option value='L&#039;Ascension' >L&#039;Ascension<\/option><option value='L&#039;Ascension-de-Notre-Seigneur' >L&#039;Ascension-de-Notre-Seigneur<\/option><option value='L&#039;Ascension-de-Patap\u00e9dia' >L&#039;Ascension-de-Patap\u00e9dia<\/option><option value='L&#039;Assomption' >L&#039;Assomption<\/option><option value='L&#039;Avenir' >L&#039;Avenir<\/option><option value='L&#039;\u00c9piphanie' >L&#039;\u00c9piphanie<\/option><option value='L&#039;\u00c9rable' >L&#039;\u00c9rable<\/option><option value='L&#039;\u00cele-Cadieux' >L&#039;\u00cele-Cadieux<\/option><option value='L&#039;\u00cele-Dorval' >L&#039;\u00cele-Dorval<\/option><option value='L&#039;\u00cele-Perrot' >L&#039;\u00cele-Perrot<\/option><option value='L&#039;\u00cele-d&#039;Anticosti' >L&#039;\u00cele-d&#039;Anticosti<\/option><option value='L&#039;\u00cele-d&#039;Orl\u00e9ans' >L&#039;\u00cele-d&#039;Orl\u00e9ans<\/option><option value='L&#039;\u00cele-du-Grand-Calumet' >L&#039;\u00cele-du-Grand-Calumet<\/option><option value='L&#039;Isle-Verte' >L&#039;Isle-Verte<\/option><option value='L&#039;Isle-aux-Allumettes' >L&#039;Isle-aux-Allumettes<\/option><option value='L&#039;Isle-aux-Coudres' >L&#039;Isle-aux-Coudres<\/option><option value='L&#039;Islet' >L&#039;Islet<\/option><option value='La Bostonnais' >La Bostonnais<\/option><option value='La Conception' >La Conception<\/option><option value='La Corne' >La Corne<\/option><option value='La C\u00f4te-de-Beaupr\u00e9' >La C\u00f4te-de-Beaupr\u00e9<\/option><option value='La C\u00f4te-de-Gasp\u00e9' >La C\u00f4te-de-Gasp\u00e9<\/option><option value='La Dor\u00e9' >La Dor\u00e9<\/option><option value='La Durantaye' >La Durantaye<\/option><option value='La Guadeloupe' >La Guadeloupe<\/option><option value='La Haute-C\u00f4te-Nord' >La Haute-C\u00f4te-Nord<\/option><option value='La Haute-Gasp\u00e9sie' >La Haute-Gasp\u00e9sie<\/option><option value='La Haute-Yamaska' >La Haute-Yamaska<\/option><option value='La Jacques-Cartier' >La Jacques-Cartier<\/option><option value='La Macaza' >La Macaza<\/option><option value='La Malbaie' >La Malbaie<\/option><option value='La Martre' >La Martre<\/option><option value='La Matanie' >La Matanie<\/option><option value='La Matap\u00e9dia' >La Matap\u00e9dia<\/option><option value='La Minerve' >La Minerve<\/option><option value='La Mitis' >La Mitis<\/option><option value='La Morandi\u00e8re' >La Morandi\u00e8re<\/option><option value='La Motte' >La Motte<\/option><option value='La Nouvelle-Beauce' >La Nouvelle-Beauce<\/option><option value='La Patrie' >La Patrie<\/option><option value='La P\u00eache' >La P\u00eache<\/option><option value='La Pocati\u00e8re' >La Pocati\u00e8re<\/option><option value='La Prairie' >La Prairie<\/option><option value='La Pr\u00e9sentation' >La Pr\u00e9sentation<\/option><option value='La R\u00e9demption' >La R\u00e9demption<\/option><option value='La Reine' >La Reine<\/option><option value='La Rivi\u00e8re-du-Nord' >La Rivi\u00e8re-du-Nord<\/option><option value='La Sarre' >La Sarre<\/option><option value='La Trinit\u00e9-des-Monts' >La Trinit\u00e9-des-Monts<\/option><option value='La Tuque' >La Tuque<\/option><option value='La Vall\u00e9e-de-l&#039;Or' >La Vall\u00e9e-de-l&#039;Or<\/option><option value='La Vall\u00e9e-de-la-Gatineau' >La Vall\u00e9e-de-la-Gatineau<\/option><option value='La Vall\u00e9e-du-Richelieu' >La Vall\u00e9e-du-Richelieu<\/option><option value='La Visitation-de-Yamaska' >La Visitation-de-Yamaska<\/option><option value='La Visitation-de-l&#039;\u00cele-Dupas' >La Visitation-de-l&#039;\u00cele-Dupas<\/option><option value='Labelle' >Labelle<\/option><option value='Labrecque' >Labrecque<\/option><option value='Lac-Beauport' >Lac-Beauport<\/option><option value='Lac-Bouchette' >Lac-Bouchette<\/option><option value='Lac-Brome' >Lac-Brome<\/option><option value='Lac-Delage' >Lac-Delage<\/option><option value='Lac-Drolet' >Lac-Drolet<\/option><option value='Lac-\u00c9douard' >Lac-\u00c9douard<\/option><option value='Lac-Etchemin' >Lac-Etchemin<\/option><option value='Lac-Fronti\u00e8re' >Lac-Fronti\u00e8re<\/option><option value='Lac-M\u00e9gantic' >Lac-M\u00e9gantic<\/option><option value='Lac-Poulin' >Lac-Poulin<\/option><option value='Lac-Saguay' >Lac-Saguay<\/option><option value='Lac-Saint-Jean-Est' >Lac-Saint-Jean-Est<\/option><option value='Lac-Saint-Joseph' >Lac-Saint-Joseph<\/option><option value='Lac-Saint-Paul' >Lac-Saint-Paul<\/option><option value='Lac-Sainte-Marie' >Lac-Sainte-Marie<\/option><option value='Lac-Sergent' >Lac-Sergent<\/option><option value='Lac-Simon' >Lac-Simon<\/option><option value='Lac-Sup\u00e9rieur' >Lac-Sup\u00e9rieur<\/option><option value='Lac-Tremblant-Nord' >Lac-Tremblant-Nord<\/option><option value='Lac-au-Saumon' >Lac-au-Saumon<\/option><option value='Lac-aux-Sables' >Lac-aux-Sables<\/option><option value='Lac-des-Aigles' >Lac-des-Aigles<\/option><option value='Lac-des-\u00c9corces' >Lac-des-\u00c9corces<\/option><option value='Lac-des-Plages' >Lac-des-Plages<\/option><option value='Lac-des-Seize-\u00celes' >Lac-des-Seize-\u00celes<\/option><option value='Lac-du-Cerf' >Lac-du-Cerf<\/option><option value='Lachute' >Lachute<\/option><option value='Lacolle' >Lacolle<\/option><option value='Laforce' >Laforce<\/option><option value='Lamarche' >Lamarche<\/option><option value='Lambton' >Lambton<\/option><option value='Landrienne' >Landrienne<\/option><option value='Lanoraie' >Lanoraie<\/option><option value='Lantier' >Lantier<\/option><option value='Larouche' >Larouche<\/option><option value='Latulipe-et-Gaboury' >Latulipe-et-Gaboury<\/option><option value='Launay' >Launay<\/option><option value='Laurier-Station' >Laurier-Station<\/option><option value='Laurierville' >Laurierville<\/option><option value='Laval' >Laval<\/option><option value='Lavaltrie' >Lavaltrie<\/option><option value='Laverloch\u00e8re Angliers' >Laverloch\u00e8re Angliers<\/option><option value='Lawrenceville' >Lawrenceville<\/option><option value='Le Domaine-du-Roy' >Le Domaine-du-Roy<\/option><option value='Le Fjord-du-Saguenay' >Le Fjord-du-Saguenay<\/option><option value='Le Golfe-du-Saint-Laurent' >Le Golfe-du-Saint-Laurent<\/option><option value='Le Granit' >Le Granit<\/option><option value='Le Haut-Richelieu' >Le Haut-Richelieu<\/option><option value='Le Haut-Saint-Fran\u00e7ois' >Le Haut-Saint-Fran\u00e7ois<\/option><option value='Le Haut-Saint-Laurent' >Le Haut-Saint-Laurent<\/option><option value='Le Rocher-Perc\u00e9' >Le Rocher-Perc\u00e9<\/option><option value='Le Val-Saint-Fran\u00e7ois' >Le Val-Saint-Fran\u00e7ois<\/option><option value='Lebel-sur-Qu\u00e9villon' >Lebel-sur-Qu\u00e9villon<\/option><option value='Leclercville' >Leclercville<\/option><option value='Lefebvre' >Lefebvre<\/option><option value='Lejeune' >Lejeune<\/option><option value='Lemieux' >Lemieux<\/option><option value='L\u00e9ry' >L\u00e9ry<\/option><option value='Les Appalaches' >Les Appalaches<\/option><option value='Les Basques' >Les Basques<\/option><option value='Les Bergeronnes' >Les Bergeronnes<\/option><option value='Les C\u00e8dres' >Les C\u00e8dres<\/option><option value='Les Chenaux' >Les Chenaux<\/option><option value='Les Collines-de-l&#039;Outaouais' >Les Collines-de-l&#039;Outaouais<\/option><option value='Les Coteaux' >Les Coteaux<\/option><option value='Les \u00c9boulements' >Les \u00c9boulements<\/option><option value='Les Escoumins' >Les Escoumins<\/option><option value='Les Etchemins' >Les Etchemins<\/option><option value='Les Hauteurs' >Les Hauteurs<\/option><option value='Les \u00celes-de-la-Madeleine' >Les \u00celes-de-la-Madeleine<\/option><option value='Les Jardins-de-Napierville' >Les Jardins-de-Napierville<\/option><option value='Les Laurentides' >Les Laurentides<\/option><option value='Les Maskoutains' >Les Maskoutains<\/option><option value='Les M\u00e9chins' >Les M\u00e9chins<\/option><option value='Les Moulins' >Les Moulins<\/option><option value='Les Pays-d&#039;en-Haut' >Les Pays-d&#039;en-Haut<\/option><option value='Les Sources' >Les Sources<\/option><option value='L\u00e9vis' >L\u00e9vis<\/option><option value='Lingwick' >Lingwick<\/option><option value='Litchfield' >Litchfield<\/option><option value='Lochaber' >Lochaber<\/option><option value='Lochaber-Partie-Ouest' >Lochaber-Partie-Ouest<\/option><option value='Longue-Pointe-de-Mingan' >Longue-Pointe-de-Mingan<\/option><option value='Longue-Rive' >Longue-Rive<\/option><option value='Longueuil' >Longueuil<\/option><option value='Lorraine' >Lorraine<\/option><option value='Lorrainville' >Lorrainville<\/option><option value='Lotbini\u00e8re' >Lotbini\u00e8re<\/option><option value='Louiseville' >Louiseville<\/option><option value='Low' >Low<\/option><option value='Lyster' >Lyster<\/option><option value='Macamic' >Macamic<\/option><option value='Maddington Falls' >Maddington Falls<\/option><option value='Magog' >Magog<\/option><option value='Malartic' >Malartic<\/option><option value='Mandeville' >Mandeville<\/option><option value='Manicouagan' >Manicouagan<\/option><option value='Maniwaki' >Maniwaki<\/option><option value='Manseau' >Manseau<\/option><option value='Mansfield-et-Pontefract' >Mansfield-et-Pontefract<\/option><option value='Marguerite-D&#039;Youville' >Marguerite-D&#039;Youville<\/option><option value='Maria' >Maria<\/option><option value='Maria-Chapdelaine' >Maria-Chapdelaine<\/option><option value='Maricourt' >Maricourt<\/option><option value='Marieville' >Marieville<\/option><option value='Marsoui' >Marsoui<\/option><option value='Marston' >Marston<\/option><option value='Martinville' >Martinville<\/option><option value='Mascouche' >Mascouche<\/option><option value='Maskinong\u00e9' >Maskinong\u00e9<\/option><option value='Massueville' >Massueville<\/option><option value='Matagami' >Matagami<\/option><option value='Matane' >Matane<\/option><option value='Matap\u00e9dia' >Matap\u00e9dia<\/option><option value='Matawinie' >Matawinie<\/option><option value='Mayo' >Mayo<\/option><option value='McMasterville' >McMasterville<\/option><option value='M\u00e9kinac' >M\u00e9kinac<\/option><option value='Melbourne' >Melbourne<\/option><option value='Memphr\u00e9magog' >Memphr\u00e9magog<\/option><option value='Mercier' >Mercier<\/option><option value='Messines' >Messines<\/option><option value='M\u00e9tabetchouan--Lac-\u00e0-la-Croix' >M\u00e9tabetchouan&#8211;Lac-\u00e0-la-Croix<\/option><option value='M\u00e9tis-sur-Mer' >M\u00e9tis-sur-Mer<\/option><option value='Milan' >Milan<\/option><option value='Mille-Isles' >Mille-Isles<\/option><option value='Minganie' >Minganie<\/option><option value='Mirabel' >Mirabel<\/option><option value='Mistissini' >Mistissini<\/option><option value='Moffet' >Moffet<\/option><option value='Mont-Carmel' >Mont-Carmel<\/option><option value='Mont-Joli' >Mont-Joli<\/option><option value='Mont-Laurier' >Mont-Laurier<\/option><option value='Mont-Royal' >Mont-Royal<\/option><option value='Mont-Saint-Gr\u00e9goire' >Mont-Saint-Gr\u00e9goire<\/option><option value='Mont-Saint-Hilaire' >Mont-Saint-Hilaire<\/option><option value='Mont-Saint-Michel' >Mont-Saint-Michel<\/option><option value='Mont-Saint-Pierre' >Mont-Saint-Pierre<\/option><option value='Mont-Tremblant' >Mont-Tremblant<\/option><option value='Montcalm' >Montcalm<\/option><option value='Montcerf-Lytton' >Montcerf-Lytton<\/option><option value='Montebello' >Montebello<\/option><option value='Montmagny' >Montmagny<\/option><option value='Montpellier' >Montpellier<\/option><option value='Montr\u00e9al' >Montr\u00e9al<\/option><option value='Montr\u00e9al-Est' >Montr\u00e9al-Est<\/option><option value='Montr\u00e9al-Ouest' >Montr\u00e9al-Ouest<\/option><option value='Morin-Heights' >Morin-Heights<\/option><option value='Mulgrave-et-Derry' >Mulgrave-et-Derry<\/option><option value='Murdochville' >Murdochville<\/option><option value='Namur' >Namur<\/option><option value='Nantes' >Nantes<\/option><option value='Napierville' >Napierville<\/option><option value='Natashquan' >Natashquan<\/option><option value='N\u00e9d\u00e9lec' >N\u00e9d\u00e9lec<\/option><option value='Nemaska' >Nemaska<\/option><option value='Neuville' >Neuville<\/option><option value='New Carlisle' >New Carlisle<\/option><option value='New Richmond' >New Richmond<\/option><option value='Newport' >Newport<\/option><option value='Nicolet' >Nicolet<\/option><option value='Nicolet-Yamaska' >Nicolet-Yamaska<\/option><option value='Nominingue' >Nominingue<\/option><option value='Normandin' >Normandin<\/option><option value='Norm\u00e9tal' >Norm\u00e9tal<\/option><option value='North Hatley' >North Hatley<\/option><option value='Notre-Dame-Auxiliatrice-de-Buckland' >Notre-Dame-Auxiliatrice-de-Buckland<\/option><option value='Notre-Dame-de-Bonsecours' >Notre-Dame-de-Bonsecours<\/option><option value='Notre-Dame-de-Ham' >Notre-Dame-de-Ham<\/option><option value='Notre-Dame-de-Lorette' >Notre-Dame-de-Lorette<\/option><option value='Notre-Dame-de-Lourdes' >Notre-Dame-de-Lourdes<\/option><option value='Notre-Dame-de-Montauban' >Notre-Dame-de-Montauban<\/option><option value='Notre-Dame-de-Pontmain' >Notre-Dame-de-Pontmain<\/option><option value='Notre-Dame-de-Stanbridge' >Notre-Dame-de-Stanbridge<\/option><option value='Notre-Dame-de-l&#039;\u00cele-Perrot' >Notre-Dame-de-l&#039;\u00cele-Perrot<\/option><option value='Notre-Dame-de-la-Merci' >Notre-Dame-de-la-Merci<\/option><option value='Notre-Dame-de-la-Paix' >Notre-Dame-de-la-Paix<\/option><option value='Notre-Dame-de-la-Salette' >Notre-Dame-de-la-Salette<\/option><option value='Notre-Dame-des-Anges' >Notre-Dame-des-Anges<\/option><option value='Notre-Dame-des-Bois' >Notre-Dame-des-Bois<\/option><option value='Notre-Dame-des-Monts' >Notre-Dame-des-Monts<\/option><option value='Notre-Dame-des-Neiges' >Notre-Dame-des-Neiges<\/option><option value='Notre-Dame-des-Pins' >Notre-Dame-des-Pins<\/option><option value='Notre-Dame-des-Prairies' >Notre-Dame-des-Prairies<\/option><option value='Notre-Dame-des-Sept-Douleurs' >Notre-Dame-des-Sept-Douleurs<\/option><option value='Notre-Dame-du-Bon-Conseil' >Notre-Dame-du-Bon-Conseil<\/option><option value='Notre-Dame-du-Bon-Conseil' >Notre-Dame-du-Bon-Conseil<\/option><option value='Notre-Dame-du-Laus' >Notre-Dame-du-Laus<\/option><option value='Notre-Dame-du-Mont-Carmel' >Notre-Dame-du-Mont-Carmel<\/option><option value='Notre-Dame-du-Nord' >Notre-Dame-du-Nord<\/option><option value='Notre-Dame-du-Portage' >Notre-Dame-du-Portage<\/option><option value='Notre-Dame-du-Rosaire' >Notre-Dame-du-Rosaire<\/option><option value='Notre-Dame-du-Sacr\u00e9-C\u0153ur-d&#039;Issoudun' >Notre-Dame-du-Sacr\u00e9-C\u0153ur-d&#039;Issoudun<\/option><option value='Nouvelle' >Nouvelle<\/option><option value='Noyan' >Noyan<\/option><option value='Ogden' >Ogden<\/option><option value='Oka' >Oka<\/option><option value='Orford' >Orford<\/option><option value='Ormstown' >Ormstown<\/option><option value='Otter Lake' >Otter Lake<\/option><option value='Otterburn Park' >Otterburn Park<\/option><option value='Packington' >Packington<\/option><option value='Padoue' >Padoue<\/option><option value='Palmarolle' >Palmarolle<\/option><option value='Papineau' >Papineau<\/option><option value='Papineauville' >Papineauville<\/option><option value='Parisville' >Parisville<\/option><option value='Pasp\u00e9biac' >Pasp\u00e9biac<\/option><option value='Perc\u00e9' >Perc\u00e9<\/option><option value='P\u00e9ribonka' >P\u00e9ribonka<\/option><option value='Petit-Saguenay' >Petit-Saguenay<\/option><option value='Petite-Rivi\u00e8re-Saint-Fran\u00e7ois' >Petite-Rivi\u00e8re-Saint-Fran\u00e7ois<\/option><option value='Petite-Vall\u00e9e' >Petite-Vall\u00e9e<\/option><option value='Piedmont' >Piedmont<\/option><option value='Pierre-De Saurel' >Pierre-De Saurel<\/option><option value='Pierreville' >Pierreville<\/option><option value='Pike-River' >Pike-River<\/option><option value='Pincourt' >Pincourt<\/option><option value='Piopolis' >Piopolis<\/option><option value='Plaisance' >Plaisance<\/option><option value='Plessisville' >Plessisville<\/option><option value='Poh\u00e9n\u00e9gamook' >Poh\u00e9n\u00e9gamook<\/option><option value='Pointe-Calumet' >Pointe-Calumet<\/option><option value='Pointe-Claire' >Pointe-Claire<\/option><option value='Pointe-Fortune' >Pointe-Fortune<\/option><option value='Pointe-Lebel' >Pointe-Lebel<\/option><option value='Pointe-\u00e0-la-Croix' >Pointe-\u00e0-la-Croix<\/option><option value='Pointe-aux-Outardes' >Pointe-aux-Outardes<\/option><option value='Pointe-des-Cascades' >Pointe-des-Cascades<\/option><option value='Pont-Rouge' >Pont-Rouge<\/option><option value='Pontiac' >Pontiac<\/option><option value='Port-Cartier' >Port-Cartier<\/option><option value='Port-Daniel--Gascons' >Port-Daniel&#8211;Gascons<\/option><option value='Portage-du-Fort' >Portage-du-Fort<\/option><option value='Portneuf-sur-Mer' >Portneuf-sur-Mer<\/option><option value='Potton' >Potton<\/option><option value='Poularies' >Poularies<\/option><option value='Preissac' >Preissac<\/option><option value='Pr\u00e9vost' >Pr\u00e9vost<\/option><option value='Price' >Price<\/option><option value='Princeville' >Princeville<\/option><option value='Puvirnituq' >Puvirnituq<\/option><option value='Quaqtaq' >Quaqtaq<\/option><option value='Qu\u00e9bec' >Quebec City<\/option><option value='Racine' >Racine<\/option><option value='Ragueneau' >Ragueneau<\/option><option value='Rapide-Danseur' >Rapide-Danseur<\/option><option value='Rapides-des-Joachims' >Rapides-des-Joachims<\/option><option value='Rawdon' >Rawdon<\/option><option value='R\u00e9migny' >R\u00e9migny<\/option><option value='Repentigny' >Repentigny<\/option><option value='Richelieu' >Richelieu<\/option><option value='Richmond' >Richmond<\/option><option value='Rigaud' >Rigaud<\/option><option value='Rimouski' >Rimouski<\/option><option value='Rimouski-Neigette' >Rimouski-Neigette<\/option><option value='Ripon' >Ripon<\/option><option value='Ristigouche-Partie-Sud-Est' >Ristigouche-Partie-Sud-Est<\/option><option value='Rivi\u00e8re-Beaudette' >Rivi\u00e8re-Beaudette<\/option><option value='Rivi\u00e8re-Bleue' >Rivi\u00e8re-Bleue<\/option><option value='Rivi\u00e8re-\u00c9ternit\u00e9' >Rivi\u00e8re-\u00c9ternit\u00e9<\/option><option value='Rivi\u00e8re-H\u00e9va' >Rivi\u00e8re-H\u00e9va<\/option><option value='Rivi\u00e8re-Ouelle' >Rivi\u00e8re-Ouelle<\/option><option value='Rivi\u00e8re-Rouge' >Rivi\u00e8re-Rouge<\/option><option value='Rivi\u00e8re-Saint-Jean' >Rivi\u00e8re-Saint-Jean<\/option><option value='Rivi\u00e8re-\u00e0-Claude' >Rivi\u00e8re-\u00e0-Claude<\/option><option value='Rivi\u00e8re-\u00e0-Pierre' >Rivi\u00e8re-\u00e0-Pierre<\/option><option value='Rivi\u00e8re-au-Tonnerre' >Rivi\u00e8re-au-Tonnerre<\/option><option value='Rivi\u00e8re-du-Loup' >Rivi\u00e8re-du-Loup<\/option><option value='Robert-Cliche' >Robert-Cliche<\/option><option value='Roberval' >Roberval<\/option><option value='Rochebaucourt' >Rochebaucourt<\/option><option value='Roquemaure' >Roquemaure<\/option><option value='Rosem\u00e8re' >Rosem\u00e8re<\/option><option value='Rougemont' >Rougemont<\/option><option value='Roussillon' >Roussillon<\/option><option value='Rouville' >Rouville<\/option><option value='Rouyn-Noranda' >Rouyn-Noranda<\/option><option value='Roxton' >Roxton<\/option><option value='Roxton Falls' >Roxton Falls<\/option><option value='Roxton Pond' >Roxton Pond<\/option><option value='Sacr\u00e9-C\u0153ur' >Sacr\u00e9-C\u0153ur<\/option><option value='Sacr\u00e9-C\u0153ur-de-J\u00e9sus' >Sacr\u00e9-C\u0153ur-de-J\u00e9sus<\/option><option value='Saguenay' >Saguenay<\/option><option value='Saint-Adalbert' >Saint-Adalbert<\/option><option value='Saint-Adelme' >Saint-Adelme<\/option><option value='Saint-Adelphe' >Saint-Adelphe<\/option><option value='Saint-Adolphe-d&#039;Howard' >Saint-Adolphe-d&#039;Howard<\/option><option value='Saint-Adrien' >Saint-Adrien<\/option><option value='Saint-Adrien-d&#039;Irlande' >Saint-Adrien-d&#039;Irlande<\/option><option value='Saint-Agapit' >Saint-Agapit<\/option><option value='Saint-Aim\u00e9' >Saint-Aim\u00e9<\/option><option value='Saint-Aim\u00e9-des-Lacs' >Saint-Aim\u00e9-des-Lacs<\/option><option value='Saint-Aim\u00e9-du-Lac-des-\u00celes' >Saint-Aim\u00e9-du-Lac-des-\u00celes<\/option><option value='Saint-Alban' >Saint-Alban<\/option><option value='Saint-Albert' >Saint-Albert<\/option><option value='Saint-Alexandre' >Saint-Alexandre<\/option><option value='Saint-Alexandre-de-Kamouraska' >Saint-Alexandre-de-Kamouraska<\/option><option value='Saint-Alexandre-des-Lacs' >Saint-Alexandre-des-Lacs<\/option><option value='Saint-Alexis' >Saint-Alexis<\/option><option value='Saint-Alexis-de-Matap\u00e9dia' >Saint-Alexis-de-Matap\u00e9dia<\/option><option value='Saint-Alexis-des-Monts' >Saint-Alexis-des-Monts<\/option><option value='Saint-Alfred' >Saint-Alfred<\/option><option value='Saint-Alphonse' >Saint-Alphonse<\/option><option value='Saint-Alphonse-Rodriguez' >Saint-Alphonse-Rodriguez<\/option><option value='Saint-Alphonse-de-Granby' >Saint-Alphonse-de-Granby<\/option><option value='Saint-Amable' >Saint-Amable<\/option><option value='Saint-Ambroise' >Saint-Ambroise<\/option><option value='Saint-Ambroise-de-Kildare' >Saint-Ambroise-de-Kildare<\/option><option value='Saint-Anaclet-de-Lessard' >Saint-Anaclet-de-Lessard<\/option><option value='Saint-Andr\u00e9' >Saint-Andr\u00e9<\/option><option value='Saint-Andr\u00e9-Avellin' >Saint-Andr\u00e9-Avellin<\/option><option value='Saint-Andr\u00e9-d&#039;Argenteuil' >Saint-Andr\u00e9-d&#039;Argenteuil<\/option><option value='Saint-Andr\u00e9-de-Restigouche' >Saint-Andr\u00e9-de-Restigouche<\/option><option value='Saint-Andr\u00e9-du-Lac-Saint-Jean' >Saint-Andr\u00e9-du-Lac-Saint-Jean<\/option><option value='Saint-Anicet' >Saint-Anicet<\/option><option value='Saint-Anselme' >Saint-Anselme<\/option><option value='Saint-Antoine-de-Tilly' >Saint-Antoine-de-Tilly<\/option><option value='Saint-Antoine-de-l&#039;Isle-aux-Grues' >Saint-Antoine-de-l&#039;Isle-aux-Grues<\/option><option value='Saint-Antoine-sur-Richelieu' >Saint-Antoine-sur-Richelieu<\/option><option value='Saint-Antonin' >Saint-Antonin<\/option><option value='Saint-Apollinaire' >Saint-Apollinaire<\/option><option value='Saint-Armand' >Saint-Armand<\/option><option value='Saint-Ars\u00e8ne' >Saint-Ars\u00e8ne<\/option><option value='Saint-Athanase' >Saint-Athanase<\/option><option value='Saint-Aubert' >Saint-Aubert<\/option><option value='Saint-Augustin' >Saint-Augustin<\/option><option value='Saint-Augustin-de-Desmaures' >Saint-Augustin-de-Desmaures<\/option><option value='Saint-Augustin-de-Woburn' >Saint-Augustin-de-Woburn<\/option><option value='Saint-Barnab\u00e9' >Saint-Barnab\u00e9<\/option><option value='Saint-Barnab\u00e9-Sud' >Saint-Barnab\u00e9-Sud<\/option><option value='Saint-Barth\u00e9lemy' >Saint-Barth\u00e9lemy<\/option><option value='Saint-Basile' >Saint-Basile<\/option><option value='Saint-Basile-le-Grand' >Saint-Basile-le-Grand<\/option><option value='Saint-Benjamin' >Saint-Benjamin<\/option><option value='Saint-Beno\u00eet-Labre' >Saint-Beno\u00eet-Labre<\/option><option value='Saint-Beno\u00eet-du-Lac' >Saint-Beno\u00eet-du-Lac<\/option><option value='Saint-Bernard' >Saint-Bernard<\/option><option value='Saint-Bernard-de-Lacolle' >Saint-Bernard-de-Lacolle<\/option><option value='Saint-Bernard-de-Michaudville' >Saint-Bernard-de-Michaudville<\/option><option value='Saint-Blaise-sur-Richelieu' >Saint-Blaise-sur-Richelieu<\/option><option value='Saint-Bonaventure' >Saint-Bonaventure<\/option><option value='Saint-Boniface' >Saint-Boniface<\/option><option value='Saint-Bruno' >Saint-Bruno<\/option><option value='Saint-Bruno-de-Guigues' >Saint-Bruno-de-Guigues<\/option><option value='Saint-Bruno-de-Kamouraska' >Saint-Bruno-de-Kamouraska<\/option><option value='Saint-Bruno-de-Montarville' >Saint-Bruno-de-Montarville<\/option><option value='Saint-Calixte' >Saint-Calixte<\/option><option value='Saint-Camille' >Saint-Camille<\/option><option value='Saint-Camille-de-Lellis' >Saint-Camille-de-Lellis<\/option><option value='Saint-Casimir' >Saint-Casimir<\/option><option value='Saint-C\u00e9lestin' >Saint-C\u00e9lestin<\/option><option value='Saint-C\u00e9saire' >Saint-C\u00e9saire<\/option><option value='Saint-Charles-Borrom\u00e9e' >Saint-Charles-Borrom\u00e9e<\/option><option value='Saint-Charles-Garnier' >Saint-Charles-Garnier<\/option><option value='Saint-Charles-de-Bellechasse' >Saint-Charles-de-Bellechasse<\/option><option value='Saint-Charles-de-Bourget' >Saint-Charles-de-Bourget<\/option><option value='Saint-Charles-sur-Richelieu' >Saint-Charles-sur-Richelieu<\/option><option value='Saint-Christophe-d&#039;Arthabaska' >Saint-Christophe-d&#039;Arthabaska<\/option><option value='Saint-Chrysostome' >Saint-Chrysostome<\/option><option value='Saint-Claude' >Saint-Claude<\/option><option value='Saint-Cl\u00e9ment' >Saint-Cl\u00e9ment<\/option><option value='Saint-Cl\u00e9ophas' >Saint-Cl\u00e9ophas<\/option><option value='Saint-Cl\u00e9ophas-de-Brandon' >Saint-Cl\u00e9ophas-de-Brandon<\/option><option value='Saint-Clet' >Saint-Clet<\/option><option value='Saint-Colomban' >Saint-Colomban<\/option><option value='Saint-C\u00f4me' >Saint-C\u00f4me<\/option><option value='Saint-C\u00f4me-Lini\u00e8re' >Saint-C\u00f4me-Lini\u00e8re<\/option><option value='Saint-Constant' >Saint-Constant<\/option><option value='Saint-Cuthbert' >Saint-Cuthbert<\/option><option value='Saint-Cyprien' >Saint-Cyprien<\/option><option value='Saint-Cyprien-de-Napierville' >Saint-Cyprien-de-Napierville<\/option><option value='Saint-Cyrille-de-Lessard' >Saint-Cyrille-de-Lessard<\/option><option value='Saint-Cyrille-de-Wendover' >Saint-Cyrille-de-Wendover<\/option><option value='Saint-Damase' >Saint-Damase<\/option><option value='Saint-Damase-de-L&#039;Islet' >Saint-Damase-de-L&#039;Islet<\/option><option value='Saint-Damien' >Saint-Damien<\/option><option value='Saint-Damien-de-Buckland' >Saint-Damien-de-Buckland<\/option><option value='Saint-David' >Saint-David<\/option><option value='Saint-David-de-Falardeau' >Saint-David-de-Falardeau<\/option><option value='Saint-Denis-de-Brompton' >Saint-Denis-de-Brompton<\/option><option value='Saint-Denis-de-la-Bouteillerie' >Saint-Denis-de-la-Bouteillerie<\/option><option value='Saint-Denis-sur-Richelieu' >Saint-Denis-sur-Richelieu<\/option><option value='Saint-Denis-sur-Richelieu' >Saint-Denis-sur-Richelieu<\/option><option value='Saint-Dominique' >Saint-Dominique<\/option><option value='Saint-Dominique-du-Rosaire' >Saint-Dominique-du-Rosaire<\/option><option value='Saint-Donat' >Saint-Donat<\/option><option value='Saint-Edmond-de-Grantham' >Saint-Edmond-de-Grantham<\/option><option value='Saint-Edmond-les-Plaines' >Saint-Edmond-les-Plaines<\/option><option value='Saint-\u00c9douard' >Saint-\u00c9douard<\/option><option value='Saint-\u00c9douard-de-Fabre' >Saint-\u00c9douard-de-Fabre<\/option><option value='Saint-\u00c9douard-de-Lotbini\u00e8re' >Saint-\u00c9douard-de-Lotbini\u00e8re<\/option><option value='Saint-\u00c9douard-de-Maskinong\u00e9' >Saint-\u00c9douard-de-Maskinong\u00e9<\/option><option value='Saint-\u00c9lie-de-Caxton' >Saint-\u00c9lie-de-Caxton<\/option><option value='Saint-\u00c9loi' >Saint-\u00c9loi<\/option><option value='Saint-Elph\u00e8ge' >Saint-Elph\u00e8ge<\/option><option value='Saint-Elz\u00e9ar' >Saint-Elz\u00e9ar<\/option><option value='Saint-Elz\u00e9ar-de-T\u00e9miscouata' >Saint-Elz\u00e9ar-de-T\u00e9miscouata<\/option><option value='Saint-\u00c9mile-de-Suffolk' >Saint-\u00c9mile-de-Suffolk<\/option><option value='Saint-\u00c9phrem-de-Beauce' >Saint-\u00c9phrem-de-Beauce<\/option><option value='Saint-\u00c9piphane' >Saint-\u00c9piphane<\/option><option value='Saint-Esprit' >Saint-Esprit<\/option><option value='Saint-\u00c9tienne-de-Beauharnois' >Saint-\u00c9tienne-de-Beauharnois<\/option><option value='Saint-\u00c9tienne-de-Bolton' >Saint-\u00c9tienne-de-Bolton<\/option><option value='Saint-\u00c9tienne-des-Gr\u00e8s' >Saint-\u00c9tienne-des-Gr\u00e8s<\/option><option value='Saint-Eug\u00e8ne' >Saint-Eug\u00e8ne<\/option><option value='Saint-Eug\u00e8ne-d&#039;Argentenay' >Saint-Eug\u00e8ne-d&#039;Argentenay<\/option><option value='Saint-Eug\u00e8ne-de-Guigues' >Saint-Eug\u00e8ne-de-Guigues<\/option><option value='Saint-Eug\u00e8ne-de-Ladri\u00e8re' >Saint-Eug\u00e8ne-de-Ladri\u00e8re<\/option><option value='Saint-Eus\u00e8be' >Saint-Eus\u00e8be<\/option><option value='Saint-Eustache' >Saint-Eustache<\/option><option value='Saint-\u00c9variste-de-Forsyth' >Saint-\u00c9variste-de-Forsyth<\/option><option value='Saint-Fabien' >Saint-Fabien<\/option><option value='Saint-Fabien-de-Panet' >Saint-Fabien-de-Panet<\/option><option value='Saint-Faustin--Lac-Carr\u00e9' >Saint-Faustin&#8211;Lac-Carr\u00e9<\/option><option value='Saint-F\u00e9licien' >Saint-F\u00e9licien<\/option><option value='Saint-F\u00e9lix-d&#039;Otis' >Saint-F\u00e9lix-d&#039;Otis<\/option><option value='Saint-F\u00e9lix-de-Dalquier' >Saint-F\u00e9lix-de-Dalquier<\/option><option value='Saint-F\u00e9lix-de-Kingsey' >Saint-F\u00e9lix-de-Kingsey<\/option><option value='Saint-F\u00e9lix-de-Valois' >Saint-F\u00e9lix-de-Valois<\/option><option value='Saint-Ferdinand' >Saint-Ferdinand<\/option><option value='Saint-Ferr\u00e9ol-les-Neiges' >Saint-Ferr\u00e9ol-les-Neiges<\/option><option value='Saint-Flavien' >Saint-Flavien<\/option><option value='Saint-Fortunat' >Saint-Fortunat<\/option><option value='Saint-Fran\u00e7ois-Xavier-de-Brompton' >Saint-Fran\u00e7ois-Xavier-de-Brompton<\/option><option value='Saint-Fran\u00e7ois-Xavier-de-Viger' >Saint-Fran\u00e7ois-Xavier-de-Viger<\/option><option value='Saint-Fran\u00e7ois-d&#039;Assise' >Saint-Fran\u00e7ois-d&#039;Assise<\/option><option value='Saint-Fran\u00e7ois-de-Sales' >Saint-Fran\u00e7ois-de-Sales<\/option><option value='Saint-Fran\u00e7ois-de-l&#039;\u00cele-d&#039;Orl\u00e9ans' >Saint-Fran\u00e7ois-de-l&#039;\u00cele-d&#039;Orl\u00e9ans<\/option><option value='Saint-Fran\u00e7ois-de-la-Rivi\u00e8re-du-Sud' >Saint-Fran\u00e7ois-de-la-Rivi\u00e8re-du-Sud<\/option><option value='Saint-Fran\u00e7ois-du-Lac' >Saint-Fran\u00e7ois-du-Lac<\/option><option value='Saint-Fr\u00e9d\u00e9ric' >Saint-Fr\u00e9d\u00e9ric<\/option><option value='Saint-Fulgence' >Saint-Fulgence<\/option><option value='Saint-Gabriel' >Saint-Gabriel<\/option><option value='Saint-Gabriel-Lalemant' >Saint-Gabriel-Lalemant<\/option><option value='Saint-Gabriel-de-Brandon' >Saint-Gabriel-de-Brandon<\/option><option value='Saint-Gabriel-de-Rimouski' >Saint-Gabriel-de-Rimouski<\/option><option value='Saint-Gabriel-de-Valcartier' >Saint-Gabriel-de-Valcartier<\/option><option value='Saint-G\u00e9d\u00e9on' >Saint-G\u00e9d\u00e9on<\/option><option value='Saint-G\u00e9d\u00e9on-de-Beauce' >Saint-G\u00e9d\u00e9on-de-Beauce<\/option><option value='Saint-Georges' >Saint-Georges<\/option><option value='Saint-Georges-de-Clarenceville' >Saint-Georges-de-Clarenceville<\/option><option value='Saint-Georges-de-Windsor' >Saint-Georges-de-Windsor<\/option><option value='Saint-G\u00e9rard-Majella' >Saint-G\u00e9rard-Majella<\/option><option value='Saint-Germain' >Saint-Germain<\/option><option value='Saint-Germain-de-Grantham' >Saint-Germain-de-Grantham<\/option><option value='Saint-Gervais' >Saint-Gervais<\/option><option value='Saint-Gilbert' >Saint-Gilbert<\/option><option value='Saint-Gilles' >Saint-Gilles<\/option><option value='Saint-Godefroi' >Saint-Godefroi<\/option><option value='Saint-Guillaume' >Saint-Guillaume<\/option><option value='Saint-Guy' >Saint-Guy<\/option><option value='Saint-Henri' >Saint-Henri<\/option><option value='Saint-Henri-de-Taillon' >Saint-Henri-de-Taillon<\/option><option value='Saint-Herm\u00e9n\u00e9gilde' >Saint-Herm\u00e9n\u00e9gilde<\/option><option value='Saint-Hilaire-de-Dorset' >Saint-Hilaire-de-Dorset<\/option><option value='Saint-Hilarion' >Saint-Hilarion<\/option><option value='Saint-Hippolyte' >Saint-Hippolyte<\/option><option value='Saint-Honor\u00e9' >Saint-Honor\u00e9<\/option><option value='Saint-Honor\u00e9-de-Shenley' >Saint-Honor\u00e9-de-Shenley<\/option><option value='Saint-Honor\u00e9-de-T\u00e9miscouata' >Saint-Honor\u00e9-de-T\u00e9miscouata<\/option><option value='Saint-Hubert-de-Rivi\u00e8re-du-Loup' >Saint-Hubert-de-Rivi\u00e8re-du-Loup<\/option><option value='Saint-Hugues' >Saint-Hugues<\/option><option value='Saint-Hyacinthe' >Saint-Hyacinthe<\/option><option value='Saint-Ignace-de-Loyola' >Saint-Ignace-de-Loyola<\/option><option value='Saint-Ignace-de-Stanbridge' >Saint-Ignace-de-Stanbridge<\/option><option value='Saint-Ir\u00e9n\u00e9e' >Saint-Ir\u00e9n\u00e9e<\/option><option value='Saint-Isidore' >Saint-Isidore<\/option><option value='Saint-Isidore-de-Clifton' >Saint-Isidore-de-Clifton<\/option><option value='Saint-Jacques' >Saint-Jacques<\/option><option value='Saint-Jacques-de-Leeds' >Saint-Jacques-de-Leeds<\/option><option value='Saint-Jacques-le-Majeur-de-Wolfestown' >Saint-Jacques-le-Majeur-de-Wolfestown<\/option><option value='Saint-Jacques-le-Mineur' >Saint-Jacques-le-Mineur<\/option><option value='Saint-Janvier-de-Joly' >Saint-Janvier-de-Joly<\/option><option value='Saint-Jean-Baptiste' >Saint-Jean-Baptiste<\/option><option value='Saint-Jean-Port-Joli' >Saint-Jean-Port-Joli<\/option><option value='Saint-Jean-de-Br\u00e9beuf' >Saint-Jean-de-Br\u00e9beuf<\/option><option value='Saint-Jean-de-Cherbourg' >Saint-Jean-de-Cherbourg<\/option><option value='Saint-Jean-de-Dieu' >Saint-Jean-de-Dieu<\/option><option value='Saint-Jean-de-Matha' >Saint-Jean-de-Matha<\/option><option value='Saint-Jean-de-l&#039;\u00cele-d&#039;Orl\u00e9ans' >Saint-Jean-de-l&#039;\u00cele-d&#039;Orl\u00e9ans<\/option><option value='Saint-Jean-de-la-Lande' >Saint-Jean-de-la-Lande<\/option><option value='Saint-Jean-sur-Richelieu' >Saint-Jean-sur-Richelieu<\/option><option value='Saint-J\u00e9r\u00f4me' >Saint-J\u00e9r\u00f4me<\/option><option value='Saint-Joachim' >Saint-Joachim<\/option><option value='Saint-Joachim-de-Shefford' >Saint-Joachim-de-Shefford<\/option><option value='Saint-Joseph-de-Beauce' >Saint-Joseph-de-Beauce<\/option><option value='Saint-Joseph-de-Coleraine' >Saint-Joseph-de-Coleraine<\/option><option value='Saint-Joseph-de-Kamouraska' >Saint-Joseph-de-Kamouraska<\/option><option value='Saint-Joseph-de-Lepage' >Saint-Joseph-de-Lepage<\/option><option value='Saint-Joseph-de-Sorel' >Saint-Joseph-de-Sorel<\/option><option value='Saint-Joseph-des-\u00c9rables' >Saint-Joseph-des-\u00c9rables<\/option><option value='Saint-Joseph-du-Lac' >Saint-Joseph-du-Lac<\/option><option value='Saint-Jude' >Saint-Jude<\/option><option value='Saint-Jules' >Saint-Jules<\/option><option value='Saint-Julien' >Saint-Julien<\/option><option value='Saint-Just-de-Breteni\u00e8res' >Saint-Just-de-Breteni\u00e8res<\/option><option value='Saint-Juste-du-Lac' >Saint-Juste-du-Lac<\/option><option value='Saint-Justin' >Saint-Justin<\/option><option value='Saint-Lambert' >Saint-Lambert<\/option><option value='Saint-Lambert-de-Lauzon' >Saint-Lambert-de-Lauzon<\/option><option value='Saint-Laurent-de-l&#039;\u00cele-d&#039;Orl\u00e9ans' >Saint-Laurent-de-l&#039;\u00cele-d&#039;Orl\u00e9ans<\/option><option value='Saint-Lazare' >Saint-Lazare<\/option><option value='Saint-Lazare-de-Bellechasse' >Saint-Lazare-de-Bellechasse<\/option><option value='Saint-L\u00e9andre' >Saint-L\u00e9andre<\/option><option value='Saint-L\u00e9on-de-Standon' >Saint-L\u00e9on-de-Standon<\/option><option value='Saint-L\u00e9on-le-Grand' >Saint-L\u00e9on-le-Grand<\/option><option value='Saint-L\u00e9onard-d&#039;Aston' >Saint-L\u00e9onard-d&#039;Aston<\/option><option value='Saint-L\u00e9onard-de-Portneuf' >Saint-L\u00e9onard-de-Portneuf<\/option><option value='Saint-Liboire' >Saint-Liboire<\/option><option value='Saint-Liguori' >Saint-Liguori<\/option><option value='Saint-Lin--Laurentides' >Saint-Lin&#8211;Laurentides<\/option><option value='Saint-Louis' >Saint-Louis<\/option><option value='Saint-Louis-de-Blandford' >Saint-Louis-de-Blandford<\/option><option value='Saint-Louis-de-Gonzague' >Saint-Louis-de-Gonzague<\/option><option value='Saint-Louis-de-Gonzague-du-Cap-Tourmente' >Saint-Louis-de-Gonzague-du-Cap-Tourmente<\/option><option value='Saint-Louis-du-Ha! Ha!' >Saint-Louis-du-Ha! Ha!<\/option><option value='Saint-Luc-de-Bellechasse' >Saint-Luc-de-Bellechasse<\/option><option value='Saint-Luc-de-Vincennes' >Saint-Luc-de-Vincennes<\/option><option value='Saint-Lucien' >Saint-Lucien<\/option><option value='Saint-Ludger' >Saint-Ludger<\/option><option value='Saint-Ludger-de-Milot' >Saint-Ludger-de-Milot<\/option><option value='Saint-Magloire' >Saint-Magloire<\/option><option value='Saint-Majorique-de-Grantham' >Saint-Majorique-de-Grantham<\/option><option value='Saint-Malachie' >Saint-Malachie<\/option><option value='Saint-Malo' >Saint-Malo<\/option><option value='Saint-Marc-de-Figuery' >Saint-Marc-de-Figuery<\/option><option value='Saint-Marc-des-Carri\u00e8res' >Saint-Marc-des-Carri\u00e8res<\/option><option value='Saint-Marc-du-Lac-Long' >Saint-Marc-du-Lac-Long<\/option><option value='Saint-Marc-sur-Richelieu' >Saint-Marc-sur-Richelieu<\/option><option value='Saint-Marcel' >Saint-Marcel<\/option><option value='Saint-Marcel-de-Richelieu' >Saint-Marcel-de-Richelieu<\/option><option value='Saint-Marcellin' >Saint-Marcellin<\/option><option value='Saint-Martin' >Saint-Martin<\/option><option value='Saint-Mathias-sur-Richelieu' >Saint-Mathias-sur-Richelieu<\/option><option value='Saint-Mathieu' >Saint-Mathieu<\/option><option value='Saint-Mathieu-d&#039;Harricana' >Saint-Mathieu-d&#039;Harricana<\/option><option value='Saint-Mathieu-de-Beloeil' >Saint-Mathieu-de-Beloeil<\/option><option value='Saint-Mathieu-de-Rioux' >Saint-Mathieu-de-Rioux<\/option><option value='Saint-Mathieu-du-Parc' >Saint-Mathieu-du-Parc<\/option><option value='Saint-Maurice' >Saint-Maurice<\/option><option value='Saint-Maxime-du-Mont-Louis' >Saint-Maxime-du-Mont-Louis<\/option><option value='Saint-M\u00e9dard' >Saint-M\u00e9dard<\/option><option value='Saint-Michel' >Saint-Michel<\/option><option value='Saint-Michel-de-Bellechasse' >Saint-Michel-de-Bellechasse<\/option><option value='Saint-Michel-des-Saints' >Saint-Michel-des-Saints<\/option><option value='Saint-Michel-du-Squatec' >Saint-Michel-du-Squatec<\/option><option value='Saint-Modeste' >Saint-Modeste<\/option><option value='Saint-Mo\u00efse' >Saint-Mo\u00efse<\/option><option value='Saint-Narcisse' >Saint-Narcisse<\/option><option value='Saint-Narcisse-de-Beaurivage' >Saint-Narcisse-de-Beaurivage<\/option><option value='Saint-Narcisse-de-Rimouski' >Saint-Narcisse-de-Rimouski<\/option><option value='Saint-Nazaire' >Saint-Nazaire<\/option><option value='Saint-Nazaire-d&#039;Acton' >Saint-Nazaire-d&#039;Acton<\/option><option value='Saint-Nazaire-de-Dorchester' >Saint-Nazaire-de-Dorchester<\/option><option value='Saint-N\u00e9r\u00e9e-de-Bellechasse' >Saint-N\u00e9r\u00e9e-de-Bellechasse<\/option><option value='Saint-No\u00ebl' >Saint-No\u00ebl<\/option><option value='Saint-Norbert' >Saint-Norbert<\/option><option value='Saint-Norbert-d&#039;Arthabaska' >Saint-Norbert-d&#039;Arthabaska<\/option><option value='Saint-Octave-de-M\u00e9tis' >Saint-Octave-de-M\u00e9tis<\/option><option value='Saint-Odilon-de-Cranbourne' >Saint-Odilon-de-Cranbourne<\/option><option value='Saint-Omer' >Saint-Omer<\/option><option value='Saint-On\u00e9sime-d&#039;Ixworth' >Saint-On\u00e9sime-d&#039;Ixworth<\/option><option value='Saint-Ours' >Saint-Ours<\/option><option value='Saint-Pac\u00f4me' >Saint-Pac\u00f4me<\/option><option value='Saint-Pamphile' >Saint-Pamphile<\/option><option value='Saint-Pascal' >Saint-Pascal<\/option><option value='Saint-Patrice-de-Beaurivage' >Saint-Patrice-de-Beaurivage<\/option><option value='Saint-Patrice-de-Sherrington' >Saint-Patrice-de-Sherrington<\/option><option value='Saint-Paul' >Saint-Paul<\/option><option value='Saint-Paul-d&#039;Abbotsford' >Saint-Paul-d&#039;Abbotsford<\/option><option value='Saint-Paul-de-Montminy' >Saint-Paul-de-Montminy<\/option><option value='Saint-Paul-de-l&#039;\u00cele-aux-Noix' >Saint-Paul-de-l&#039;\u00cele-aux-Noix<\/option><option value='Saint-Paul-de-la-Croix' >Saint-Paul-de-la-Croix<\/option><option value='Saint-Paulin' >Saint-Paulin<\/option><option value='Saint-Phil\u00e9mon' >Saint-Phil\u00e9mon<\/option><option value='Saint-Philibert' >Saint-Philibert<\/option><option value='Saint-Philippe' >Saint-Philippe<\/option><option value='Saint-Philippe-de-N\u00e9ri' >Saint-Philippe-de-N\u00e9ri<\/option><option value='Saint-Pie' >Saint-Pie<\/option><option value='Saint-Pie-de-Guire' >Saint-Pie-de-Guire<\/option><option value='Saint-Pierre' >Saint-Pierre<\/option><option value='Saint-Pierre-Baptiste' >Saint-Pierre-Baptiste<\/option><option value='Saint-Pierre-de-Broughton' >Saint-Pierre-de-Broughton<\/option><option value='Saint-Pierre-de-Lamy' >Saint-Pierre-de-Lamy<\/option><option value='Saint-Pierre-de-l&#039;\u00cele-d&#039;Orl\u00e9ans' >Saint-Pierre-de-l&#039;\u00cele-d&#039;Orl\u00e9ans<\/option><option value='Saint-Pierre-de-la-Rivi\u00e8re-du-Sud' >Saint-Pierre-de-la-Rivi\u00e8re-du-Sud<\/option><option value='Saint-Pierre-les-Becquets' >Saint-Pierre-les-Becquets<\/option><option value='Saint-Placide' >Saint-Placide<\/option><option value='Saint-Polycarpe' >Saint-Polycarpe<\/option><option value='Saint-Prime' >Saint-Prime<\/option><option value='Saint-Prosper' >Saint-Prosper<\/option><option value='Saint-Prosper-de-Champlain' >Saint-Prosper-de-Champlain<\/option><option value='Saint-Rapha\u00ebl' >Saint-Rapha\u00ebl<\/option><option value='Saint-Raymond' >Saint-Raymond<\/option><option value='Saint-R\u00e9mi' >Saint-R\u00e9mi<\/option><option value='Saint-R\u00e9mi-de-Tingwick' >Saint-R\u00e9mi-de-Tingwick<\/option><option value='Saint-Ren\u00e9' >Saint-Ren\u00e9<\/option><option value='Saint-Ren\u00e9-de-Matane' >Saint-Ren\u00e9-de-Matane<\/option><option value='Saint-Robert' >Saint-Robert<\/option><option value='Saint-Robert-Bellarmin' >Saint-Robert-Bellarmin<\/option><option value='Saint-Roch-Ouest' >Saint-Roch-Ouest<\/option><option value='Saint-Roch-de-M\u00e9kinac' >Saint-Roch-de-M\u00e9kinac<\/option><option value='Saint-Roch-de-Richelieu' >Saint-Roch-de-Richelieu<\/option><option value='Saint-Roch-de-l&#039;Achigan' >Saint-Roch-de-l&#039;Achigan<\/option><option value='Saint-Roch-des-Aulnaies' >Saint-Roch-des-Aulnaies<\/option><option value='Saint-Romain' >Saint-Romain<\/option><option value='Saint-Rosaire' >Saint-Rosaire<\/option><option value='Saint-Samuel' >Saint-Samuel<\/option><option value='Saint-Sauveur' >Saint-Sauveur<\/option><option value='Saint-S\u00e9bastien' >Saint-S\u00e9bastien<\/option><option value='Saint-S\u00e9v\u00e8re' >Saint-S\u00e9v\u00e8re<\/option><option value='Saint-S\u00e9verin' >Saint-S\u00e9verin<\/option><option value='Saint-Sim\u00e9on' >Saint-Sim\u00e9on<\/option><option value='Saint-Simon' >Saint-Simon<\/option><option value='Saint-Simon-les-Mines' >Saint-Simon-les-Mines<\/option><option value='Saint-Sixte' >Saint-Sixte<\/option><option value='Saint-Stanislas' >Saint-Stanislas<\/option><option value='Saint-Stanislas-de-Kostka' >Saint-Stanislas-de-Kostka<\/option><option value='Saint-Sulpice' >Saint-Sulpice<\/option><option value='Saint-Sylv\u00e8re' >Saint-Sylv\u00e8re<\/option><option value='Saint-Sylvestre' >Saint-Sylvestre<\/option><option value='Saint-T\u00e9lesphore' >Saint-T\u00e9lesphore<\/option><option value='Saint-Tharcisius' >Saint-Tharcisius<\/option><option value='Saint-Th\u00e9odore-d&#039;Acton' >Saint-Th\u00e9odore-d&#039;Acton<\/option><option value='Saint-Th\u00e9ophile' >Saint-Th\u00e9ophile<\/option><option value='Saint-Thomas' >Saint-Thomas<\/option><option value='Saint-Thomas-Didyme' >Saint-Thomas-Didyme<\/option><option value='Saint-Thuribe' >Saint-Thuribe<\/option><option value='Saint-Tite' >Saint-Tite<\/option><option value='Saint-Tite-des-Caps' >Saint-Tite-des-Caps<\/option><option value='Saint-Ubalde' >Saint-Ubalde<\/option><option value='Saint-Ulric' >Saint-Ulric<\/option><option value='Saint-Valentin' >Saint-Valentin<\/option><option value='Saint-Val\u00e8re' >Saint-Val\u00e8re<\/option><option value='Saint-Val\u00e9rien' >Saint-Val\u00e9rien<\/option><option value='Saint-Val\u00e9rien-de-Milton' >Saint-Val\u00e9rien-de-Milton<\/option><option value='Saint-Vallier' >Saint-Vallier<\/option><option value='Saint-Venant-de-Paquette' >Saint-Venant-de-Paquette<\/option><option value='Saint-Vianney' >Saint-Vianney<\/option><option value='Saint-Victor' >Saint-Victor<\/option><option value='Saint-Wenceslas' >Saint-Wenceslas<\/option><option value='Saint-Zacharie' >Saint-Zacharie<\/option><option value='Saint-Z\u00e9non' >Saint-Z\u00e9non<\/option><option value='Saint-Z\u00e9non-du-Lac-Humqui' >Saint-Z\u00e9non-du-Lac-Humqui<\/option><option value='Saint-Z\u00e9phirin-de-Courval' >Saint-Z\u00e9phirin-de-Courval<\/option><option value='Saint-Zotique' >Saint-Zotique<\/option><option value='Sainte-Ad\u00e8le' >Sainte-Ad\u00e8le<\/option><option value='Sainte-Agathe-de-Lotbini\u00e8re' >Sainte-Agathe-de-Lotbini\u00e8re<\/option><option value='Sainte-Agathe-des-Monts' >Sainte-Agathe-des-Monts<\/option><option value='Sainte-Ang\u00e8le-de-M\u00e9rici' >Sainte-Ang\u00e8le-de-M\u00e9rici<\/option><option value='Sainte-Ang\u00e8le-de-Monnoir' >Sainte-Ang\u00e8le-de-Monnoir<\/option><option value='Sainte-Ang\u00e8le-de-Pr\u00e9mont' >Sainte-Ang\u00e8le-de-Pr\u00e9mont<\/option><option value='Sainte-Anne-de-Beaupr\u00e9' >Sainte-Anne-de-Beaupr\u00e9<\/option><option value='Sainte-Anne-de-Bellevue' >Sainte-Anne-de-Bellevue<\/option><option value='Sainte-Anne-de-Sabrevois' >Sainte-Anne-de-Sabrevois<\/option><option value='Sainte-Anne-de-Sorel' >Sainte-Anne-de-Sorel<\/option><option value='Sainte-Anne-de-la-P\u00e9rade' >Sainte-Anne-de-la-P\u00e9rade<\/option><option value='Sainte-Anne-de-la-Pocati\u00e8re' >Sainte-Anne-de-la-Pocati\u00e8re<\/option><option value='Sainte-Anne-de-la-Rochelle' >Sainte-Anne-de-la-Rochelle<\/option><option value='Sainte-Anne-des-Lacs' >Sainte-Anne-des-Lacs<\/option><option value='Sainte-Anne-des-Monts' >Sainte-Anne-des-Monts<\/option><option value='Sainte-Anne-des-Plaines' >Sainte-Anne-des-Plaines<\/option><option value='Sainte-Anne-du-Lac' >Sainte-Anne-du-Lac<\/option><option value='Sainte-Apolline-de-Patton' >Sainte-Apolline-de-Patton<\/option><option value='Sainte-Aur\u00e9lie' >Sainte-Aur\u00e9lie<\/option><option value='Sainte-Barbe' >Sainte-Barbe<\/option><option value='Sainte-B\u00e9atrix' >Sainte-B\u00e9atrix<\/option><option value='Sainte-Brigide-d&#039;Iberville' >Sainte-Brigide-d&#039;Iberville<\/option><option value='Sainte-Brigitte-de-Laval' >Sainte-Brigitte-de-Laval<\/option><option value='Sainte-Brigitte-des-Saults' >Sainte-Brigitte-des-Saults<\/option><option value='Sainte-Catherine' >Sainte-Catherine<\/option><option value='Sainte-Catherine-de-Hatley' >Sainte-Catherine-de-Hatley<\/option><option value='Sainte-Catherine-de-la-Jacques-Cartier' >Sainte-Catherine-de-la-Jacques-Cartier<\/option><option value='Sainte-C\u00e9cile-de-L\u00e9vrard' >Sainte-C\u00e9cile-de-L\u00e9vrard<\/option><option value='Sainte-C\u00e9cile-de-Milton' >Sainte-C\u00e9cile-de-Milton<\/option><option value='Sainte-C\u00e9cile-de-Whitton' >Sainte-C\u00e9cile-de-Whitton<\/option><option value='Sainte-Christine' >Sainte-Christine<\/option><option value='Sainte-Christine-d&#039;Auvergne' >Sainte-Christine-d&#039;Auvergne<\/option><option value='Sainte-Claire' >Sainte-Claire<\/option><option value='Sainte-Clotilde' >Sainte-Clotilde<\/option><option value='Sainte-Clotilde-de-Beauce' >Sainte-Clotilde-de-Beauce<\/option><option value='Sainte-Clotilde-de-Horton' >Sainte-Clotilde-de-Horton<\/option><option value='Sainte-Croix' >Sainte-Croix<\/option><option value='Sainte-Edwidge-de-Clifton' >Sainte-Edwidge-de-Clifton<\/option><option value='Sainte-\u00c9lisabeth' >Sainte-\u00c9lisabeth<\/option><option value='Sainte-\u00c9lizabeth-de-Warwick' >Sainte-\u00c9lizabeth-de-Warwick<\/option><option value='Sainte-\u00c9m\u00e9lie-de-l&#039;\u00c9nergie' >Sainte-\u00c9m\u00e9lie-de-l&#039;\u00c9nergie<\/option><option value='Sainte-Eulalie' >Sainte-Eulalie<\/option><option value='Sainte-Euph\u00e9mie-sur-Rivi\u00e8re-du-Sud' >Sainte-Euph\u00e9mie-sur-Rivi\u00e8re-du-Sud<\/option><option value='Sainte-Famille-de-l\u2019\u00cele-d\u2019Orl\u00e9ans' >Sainte-Famille-de-l\u2019\u00cele-d\u2019Orl\u00e9ans<\/option><option value='Sainte-F\u00e9licit\u00e9' >Sainte-F\u00e9licit\u00e9<\/option><option value='Sainte-Flavie' >Sainte-Flavie<\/option><option value='Sainte-Florence' >Sainte-Florence<\/option><option value='Sainte-Fran\u00e7oise' >Sainte-Fran\u00e7oise<\/option><option value='Sainte-Genevi\u00e8ve-de-Batiscan' >Sainte-Genevi\u00e8ve-de-Batiscan<\/option><option value='Sainte-Genevi\u00e8ve-de-Berthier' >Sainte-Genevi\u00e8ve-de-Berthier<\/option><option value='Sainte-Germaine-Boul\u00e9' >Sainte-Germaine-Boul\u00e9<\/option><option value='Sainte-Gertrude-Manneville' >Sainte-Gertrude-Manneville<\/option><option value='Sainte-Hedwidge' >Sainte-Hedwidge<\/option><option value='Sainte-H\u00e9l\u00e8ne-de-Bagot' >Sainte-H\u00e9l\u00e8ne-de-Bagot<\/option><option value='Sainte-H\u00e9l\u00e8ne-de-Chester' >Sainte-H\u00e9l\u00e8ne-de-Chester<\/option><option value='Sainte-H\u00e9l\u00e8ne-de-Kamouraska' >Sainte-H\u00e9l\u00e8ne-de-Kamouraska<\/option><option value='Sainte-H\u00e9l\u00e8ne-de-Mancebourg' >Sainte-H\u00e9l\u00e8ne-de-Mancebourg<\/option><option value='Sainte-H\u00e9n\u00e9dine' >Sainte-H\u00e9n\u00e9dine<\/option><option value='Sainte-Ir\u00e8ne' >Sainte-Ir\u00e8ne<\/option><option value='Sainte-Jeanne-d&#039;Arc' >Sainte-Jeanne-d&#039;Arc<\/option><option value='Sainte-Julie' >Sainte-Julie<\/option><option value='Sainte-Julienne' >Sainte-Julienne<\/option><option value='Sainte-Justine' >Sainte-Justine<\/option><option value='Sainte-Justine-de-Newton' >Sainte-Justine-de-Newton<\/option><option value='Sainte-Louise' >Sainte-Louise<\/option><option value='Sainte-Luce' >Sainte-Luce<\/option><option value='Sainte-Lucie-de-Beauregard' >Sainte-Lucie-de-Beauregard<\/option><option value='Sainte-Lucie-des-Laurentides' >Sainte-Lucie-des-Laurentides<\/option><option value='Sainte-Madeleine' >Sainte-Madeleine<\/option><option value='Sainte-Madeleine-de-la-Rivi\u00e8re-Madeleine' >Sainte-Madeleine-de-la-Rivi\u00e8re-Madeleine<\/option><option value='Sainte-Marcelline-de-Kildare' >Sainte-Marcelline-de-Kildare<\/option><option value='Sainte-Marguerite' >Sainte-Marguerite<\/option><option value='Sainte-Marguerite-Marie' >Sainte-Marguerite-Marie<\/option><option value='Sainte-Marguerite-du-Lac-Masson' >Sainte-Marguerite-du-Lac-Masson<\/option><option value='Sainte-Marie' >Sainte-Marie<\/option><option value='Sainte-Marie-Madeleine' >Sainte-Marie-Madeleine<\/option><option value='Sainte-Marie-Salom\u00e9' >Sainte-Marie-Salom\u00e9<\/option><option value='Sainte-Marie-de-Blandford' >Sainte-Marie-de-Blandford<\/option><option value='Sainte-Marthe' >Sainte-Marthe<\/option><option value='Sainte-Marthe-sur-le-Lac' >Sainte-Marthe-sur-le-Lac<\/option><option value='Sainte-Martine' >Sainte-Martine<\/option><option value='Sainte-M\u00e9lanie' >Sainte-M\u00e9lanie<\/option><option value='Sainte-Monique' >Sainte-Monique<\/option><option value='Sainte-Paule' >Sainte-Paule<\/option><option value='Sainte-Perp\u00e9tue' >Sainte-Perp\u00e9tue<\/option><option value='Sainte-P\u00e9tronille' >Sainte-P\u00e9tronille<\/option><option value='Sainte-Prax\u00e8de' >Sainte-Prax\u00e8de<\/option><option value='Sainte-Rita' >Sainte-Rita<\/option><option value='Sainte-Rose-de-Watford' >Sainte-Rose-de-Watford<\/option><option value='Sainte-Rose-du-Nord' >Sainte-Rose-du-Nord<\/option><option value='Sainte-Sabine' >Sainte-Sabine<\/option><option value='Sainte-S\u00e9raphine' >Sainte-S\u00e9raphine<\/option><option value='Sainte-Sophie' >Sainte-Sophie<\/option><option value='Sainte-Sophie-d&#039;Halifax' >Sainte-Sophie-d&#039;Halifax<\/option><option value='Sainte-Sophie-de-L\u00e9vrard' >Sainte-Sophie-de-L\u00e9vrard<\/option><option value='Sainte-Th\u00e8cle' >Sainte-Th\u00e8cle<\/option><option value='Sainte-Th\u00e9r\u00e8se' >Sainte-Th\u00e9r\u00e8se<\/option><option value='Sainte-Th\u00e9r\u00e8se-de-Gasp\u00e9' >Sainte-Th\u00e9r\u00e8se-de-Gasp\u00e9<\/option><option value='Sainte-Th\u00e9r\u00e8se-de-la-Gatineau' >Sainte-Th\u00e9r\u00e8se-de-la-Gatineau<\/option><option value='Sainte-Ursule' >Sainte-Ursule<\/option><option value='Sainte-Victoire-de-Sorel' >Sainte-Victoire-de-Sorel<\/option><option value='Saints-Anges' >Saints-Anges<\/option><option value='Saints-Martyrs-Canadiens' >Saints-Martyrs-Canadiens<\/option><option value='Salaberry-de-Valleyfield' >Salaberry-de-Valleyfield<\/option><option value='Salluit' >Salluit<\/option><option value='Sayabec' >Sayabec<\/option><option value='Schefferville' >Schefferville<\/option><option value='Scotstown' >Scotstown<\/option><option value='Scott' >Scott<\/option><option value='Senneterre' >Senneterre<\/option><option value='Senneville' >Senneville<\/option><option value='Sept-\u00celes' >Sept-\u00celes<\/option><option value='Sept-Rivi\u00e8res' >Sept-Rivi\u00e8res<\/option><option value='Shannon' >Shannon<\/option><option value='Shawinigan' >Shawinigan<\/option><option value='Shawville' >Shawville<\/option><option value='Sheenboro' >Sheenboro<\/option><option value='Shefford' >Shefford<\/option><option value='Sherbrooke' >Sherbrooke<\/option><option value='Shigawake' >Shigawake<\/option><option value='Sorel-Tracy' >Sorel-Tracy<\/option><option value='Stanbridge East' >Stanbridge East<\/option><option value='Stanbridge Station' >Stanbridge Station<\/option><option value='Stanstead' >Stanstead<\/option><option value='Stanstead-Est' >Stanstead-Est<\/option><option value='Stoke' >Stoke<\/option><option value='Stoneham-et-Tewkesbury' >Stoneham-et-Tewkesbury<\/option><option value='Stornoway' >Stornoway<\/option><option value='Stratford' >Stratford<\/option><option value='Stukely-Sud' >Stukely-Sud<\/option><option value='Sutton' >Sutton<\/option><option value='Tadoussac' >Tadoussac<\/option><option value='Taschereau' >Taschereau<\/option><option value='Tasiujaq' >Tasiujaq<\/option><option value='T\u00e9miscaming' >T\u00e9miscaming<\/option><option value='T\u00e9miscamingue' >T\u00e9miscamingue<\/option><option value='T\u00e9miscouata' >T\u00e9miscouata<\/option><option value='T\u00e9miscouata-sur-le-Lac' >T\u00e9miscouata-sur-le-Lac<\/option><option value='Terrasse-Vaudreuil' >Terrasse-Vaudreuil<\/option><option value='Terrebonne' >Terrebonne<\/option><option value='Th\u00e9r\u00e8se-De Blainville' >Th\u00e9r\u00e8se-De Blainville<\/option><option value='Thetford Mines' >Thetford Mines<\/option><option value='Thorne' >Thorne<\/option><option value='Thurso' >Thurso<\/option><option value='Tingwick' >Tingwick<\/option><option value='Tourville' >Tourville<\/option><option value='Tr\u00e9cesson' >Tr\u00e9cesson<\/option><option value='Tr\u00e8s-Saint-R\u00e9dempteur' >Tr\u00e8s-Saint-R\u00e9dempteur<\/option><option value='Tr\u00e8s-Saint-Sacrement' >Tr\u00e8s-Saint-Sacrement<\/option><option value='Tring-Jonction' >Tring-Jonction<\/option><option value='Trois-Pistoles' >Trois-Pistoles<\/option><option value='Trois-Rives' >Trois-Rives<\/option><option value='Trois-Rivi\u00e8res' >Trois-Rivi\u00e8res<\/option><option value='Ulverton' >Ulverton<\/option><option value='Umiujaq' >Umiujaq<\/option><option value='Upton' >Upton<\/option><option value='Val-Alain' >Val-Alain<\/option><option value='Val-Brillant' >Val-Brillant<\/option><option value='Val-David' >Val-David<\/option><option value='Val-Joli' >Val-Joli<\/option><option value='Val-Morin' >Val-Morin<\/option><option value='Val-Racine' >Val-Racine<\/option><option value='Val-Saint-Gilles' >Val-Saint-Gilles<\/option><option value='Val-d&#039;Or' >Val-d&#039;Or<\/option><option value='Val-des-Bois' >Val-des-Bois<\/option><option value='Val-des-Lacs' >Val-des-Lacs<\/option><option value='Val-des-Monts' >Val-des-Monts<\/option><option value='Valcourt' >Valcourt<\/option><option value='Valcourt' >Valcourt<\/option><option value='Vall\u00e9e-Jonction' >Vall\u00e9e-Jonction<\/option><option value='Varennes' >Varennes<\/option><option value='Vaudreuil-Dorion' >Vaudreuil-Dorion<\/option><option value='Vaudreuil-Soulanges' >Vaudreuil-Soulanges<\/option><option value='Vaudreuil-sur-le-Lac' >Vaudreuil-sur-le-Lac<\/option><option value='Venise-en-Qu\u00e9bec' >Venise-en-Qu\u00e9bec<\/option><option value='Verch\u00e8res' >Verch\u00e8res<\/option><option value='Victoriaville' >Victoriaville<\/option><option value='Ville-Marie' >Ville-Marie<\/option><option value='Villeroy' >Villeroy<\/option><option value='Waltham' >Waltham<\/option><option value='Warden' >Warden<\/option><option value='Warwick' >Warwick<\/option><option value='Waskaganish' >Waskaganish<\/option><option value='Waswanipi' >Waswanipi<\/option><option value='Waterloo' >Waterloo<\/option><option value='Waterville' >Waterville<\/option><option value='Weedon' >Weedon<\/option><option value='Wemindji' >Wemindji<\/option><option value='Wentworth' >Wentworth<\/option><option value='Wentworth-Nord' >Wentworth-Nord<\/option><option value='Westbury' >Westbury<\/option><option value='Westmount' >Westmount<\/option><option value='Whapmagoostui' >Whapmagoostui<\/option><option value='Wickham' >Wickham<\/option><option value='Windsor' >Windsor<\/option><option value='Wotton' >Wotton<\/option><option value='Yamachiche' >Yamachiche<\/option><option value='Yamaska' >Yamaska<\/option><\/select><\/div><\/div><fieldset id=\"field_2_10\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >1T &#8211; Ville ou village<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_10'><div class='gchoice gchoice_2_10_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.1' type='checkbox'  value='Je pr\u00e9f\u00e8re ne pas r\u00e9pondre'  id='choice_2_10_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_10_1' id='label_2_10_1' class='gform-field-label gform-field-label--type-inline'>I prefer not to answer<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_19\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Are you&#8230;*<\/h3><\/div><fieldset id=\"field_2_23\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >1T &#8211; LGBTQI+?<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_2_23'>\n\t\t\t<div class='gchoice gchoice_2_23_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='LGBTQI+'  id='choice_2_23_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_23_0' id='label_2_23_0' class='gform-field-label gform-field-label--type-inline'>LGBTQI+<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_23_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='Alli\u00e9e'  id='choice_2_23_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_23_1' id='label_2_23_1' class='gform-field-label gform-field-label--type-inline'>An ally <\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_23_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='En questionnement'  id='choice_2_23_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_23_2' id='label_2_23_2' class='gform-field-label gform-field-label--type-inline'>Questioning<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_21\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >1T &#8211; LGBTQI+<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_21'><div class='gchoice gchoice_2_21_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.1' type='checkbox'  value='Lesbienne'  id='choice_2_21_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_21_1' id='label_2_21_1' class='gform-field-label gform-field-label--type-inline'>Lesbian<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_21_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.2' type='checkbox'  value='Gaie'  id='choice_2_21_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_21_2' id='label_2_21_2' class='gform-field-label gform-field-label--type-inline'>Gay<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_21_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.3' type='checkbox'  value='Bisexuelle'  id='choice_2_21_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_21_3' id='label_2_21_3' class='gform-field-label gform-field-label--type-inline'>Bisexual<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_21_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.4' type='checkbox'  value='Trans'  id='choice_2_21_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_21_4' id='label_2_21_4' class='gform-field-label gform-field-label--type-inline'>Trans<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_21_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.5' type='checkbox'  value='Queer'  id='choice_2_21_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_21_5' id='label_2_21_5' class='gform-field-label gform-field-label--type-inline'>Queer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_21_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.6' type='checkbox'  value='Intersexe'  id='choice_2_21_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_21_6' id='label_2_21_6' class='gform-field-label gform-field-label--type-inline'>Intersex<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_21_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.7' type='checkbox'  value='Non-binaire'  id='choice_2_21_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_21_7' id='label_2_21_7' class='gform-field-label gform-field-label--type-inline'>Non-binary<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_21_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.8' type='checkbox'  value='Pansexuelle'  id='choice_2_21_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_21_8' id='label_2_21_8' class='gform-field-label gform-field-label--type-inline'>Pansexual<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_21_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.9' type='checkbox'  value='Asexuelle'  id='choice_2_21_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_21_9' id='label_2_21_9' class='gform-field-label gform-field-label--type-inline'>Asexual<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_21_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.11' type='checkbox'  value='En questionnement'  id='choice_2_21_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_21_11' id='label_2_21_11' class='gform-field-label gform-field-label--type-inline'>Questioning<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_21_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.12' type='checkbox'  value='Bispirituelle'  id='choice_2_21_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_21_12' id='label_2_21_12' class='gform-field-label gform-field-label--type-inline'>Two-spirit<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_21_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.13' type='checkbox'  value='Autre(s) (pr\u00e9ciser)'  id='choice_2_21_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_21_13' id='label_2_21_13' class='gform-field-label gform-field-label--type-inline'>Other(s) (Please specify)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_21_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.14' type='checkbox'  value='Je pr\u00e9f\u00e8re ne pas r\u00e9pondre'  id='choice_2_21_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_21_14' id='label_2_21_14' class='gform-field-label gform-field-label--type-inline'>I prefer not to answer<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_22\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_22'>Other(s)<\/label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_2_22' type='text' value='' class='large' maxlength='350'     aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_24\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Do you have a connection to the person or the people targeted by this situation?*<\/h3><\/div><fieldset id=\"field_2_25\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >1T &#8211; Lien avec personne(s) cibl\u00e9e(s)<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_2_25'>\n\t\t\t<div class='gchoice gchoice_2_25_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='Oui'  id='choice_2_25_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_25_0' id='label_2_25_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_25_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='Non'  id='choice_2_25_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_25_1' id='label_2_25_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_26\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Connection to the person or the people targeted<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_2_26'><div class='gchoice gchoice_2_26_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.1' type='checkbox'  value='Lien familial'  id='choice_2_26_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_26_1' id='label_2_26_1' class='gform-field-label gform-field-label--type-inline'>Family member <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_26_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.2' type='checkbox'  value='Lien amical'  id='choice_2_26_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_26_2' id='label_2_26_2' class='gform-field-label gform-field-label--type-inline'>Friend <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_26_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.3' type='checkbox'  value='Lien intime ou amoureux'  id='choice_2_26_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_26_3' id='label_2_26_3' class='gform-field-label gform-field-label--type-inline'>Intimate, romantic or sexual partner <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_26_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.4' type='checkbox'  value='Coll\u00e8gue de travail'  id='choice_2_26_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_26_4' id='label_2_26_4' class='gform-field-label gform-field-label--type-inline'>Colleague <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_26_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.5' type='checkbox'  value='Colocataire'  id='choice_2_26_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_26_5' id='label_2_26_5' class='gform-field-label gform-field-label--type-inline'>Roommate <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_26_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.6' type='checkbox'  value='Je pr\u00e9f\u00e8re ne pas r\u00e9pondre'  id='choice_2_26_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_26_6' id='label_2_26_6' class='gform-field-label gform-field-label--type-inline'>I prefer not to answer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_26_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.7' type='checkbox'  value='Autre (pr\u00e9ciser)'  id='choice_2_26_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_26_7' id='label_2_26_7' class='gform-field-label gform-field-label--type-inline'>Other(s) (Please specify)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_27\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_27'>Other(s)<\/label><div class='ginput_container ginput_container_text'><input name='input_27' id='input_2_27' type='text' value='' class='large' maxlength='350'     aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_2_40' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_2_2' class='gform_page' data-js='page-field-id-40' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_2_2' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_2_28\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">2.  IDENTIFICATION OF VIOLENCE WITNESSED <\/h3><\/div><div id=\"field_2_29\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Was this situation targeting one person or several people?*<\/h3><\/div><fieldset id=\"field_2_30\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >2T &#8211; Nombre de personne victime<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_2_30'>\n\t\t\t<div class='gchoice gchoice_2_30_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='Une personne'  id='choice_2_30_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_30_0' id='label_2_30_0' class='gform-field-label gform-field-label--type-inline'>One person<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_30_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='Plusieurs personnes'  id='choice_2_30_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_30_1' id='label_2_30_1' class='gform-field-label gform-field-label--type-inline'>Several people<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_31\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >2T &#8211; Plusieurs personnes<\/legend><div class='gfield_description' id='gfield_description_2_31'>Specify at the best of your knowledge<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_31'>\n\t\t\t<div class='gchoice gchoice_2_31_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='2 personnes'  id='choice_2_31_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_2_31\"   \/>\n\t\t\t\t\t<label for='choice_2_31_0' id='label_2_31_0' class='gform-field-label gform-field-label--type-inline'>2 people <\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_31_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='Entre 3 et 5 personnes'  id='choice_2_31_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_31_1' id='label_2_31_1' class='gform-field-label gform-field-label--type-inline'>Between 3 and 5 people <\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_31_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='Plus de 5 personnes'  id='choice_2_31_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_31_2' id='label_2_31_2' class='gform-field-label gform-field-label--type-inline'>More than 5 people <\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_32\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">What types of violent behaviour did you witness in this situation?*<\/h3><div class='gsection_description' id='gfield_description_2_32'>You can select more than one option.<\/div><\/div><fieldset id=\"field_2_33\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >2T &#8211; Type de violence<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_2_33'><div class='gchoice gchoice_2_33_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.1' type='checkbox'  value='Psychologique ou verbale'  id='choice_2_33_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_33_1' id='label_2_33_1' class='gform-field-label gform-field-label--type-inline'>Psychological or verbal <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_33_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.2' type='checkbox'  value='Physique'  id='choice_2_33_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_33_2' id='label_2_33_2' class='gform-field-label gform-field-label--type-inline'>Physical<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_33_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.3' type='checkbox'  value='Sexuelle'  id='choice_2_33_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_33_3' id='label_2_33_3' class='gform-field-label gform-field-label--type-inline'>Sexual<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_33_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.4' type='checkbox'  value='Cyberviolence'  id='choice_2_33_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_33_4' id='label_2_33_4' class='gform-field-label gform-field-label--type-inline'>Cyberviolence<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_33_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.5' type='checkbox'  value='N\u00e9gligence'  id='choice_2_33_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_33_5' id='label_2_33_5' class='gform-field-label gform-field-label--type-inline'>Negligence<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_33_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.6' type='checkbox'  value='En lien avec la religion ou la spiritualit\u00e9'  id='choice_2_33_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_33_6' id='label_2_33_6' class='gform-field-label gform-field-label--type-inline'>Religious or spiritual abuse<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_33_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.7' type='checkbox'  value='\u00c9conomique'  id='choice_2_33_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_33_7' id='label_2_33_7' class='gform-field-label gform-field-label--type-inline'>Financial<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_33_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.8' type='checkbox'  value='Syst\u00e9mique'  id='choice_2_33_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_33_8' id='label_2_33_8' class='gform-field-label gform-field-label--type-inline'>Systemic<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='mm_tooltip_text' style='display:none'><hr \/><p>FR : Attitude, parole ou geste qui vise \u00e0 diminuer, voire d\u00e9truire l\u2019estime de soi ou le sentiment de s\u00e9curit\u00e9 d\u2019une autre personne de fa\u00e7on \u00e0 la maintenir en position d\u2019inf\u00e9riorit\u00e9 | EN : Attitude, speech or gesture that aims to diminish or destroy another person\u2019s self-esteem or sense of security in order to keep them in an inferior position\u00a0<\/p><hr \/><p>FR : Geste impliquant un contact physique avec une personne ou un objet, qui vise \u00e0 blesser, menacer ou faire peur | EN : Gesture involving physical contact with a person or object, intended to injure, threaten or frighten<\/p><hr \/><p>FR : Tout geste \u00e0 caract\u00e8re sexuel non consenti, verbal ou non verbal, isol\u00e9 ou r\u00e9p\u00e9t\u00e9; toute tentative d\u2019acte sexuel ou tout autre acte exerc\u00e9 par autrui contre la sexualit\u00e9 d\u2019une personne en faisant usage de la force, quelle que soit sa relation avec la victime, dans n\u2019importe quel contexte | EN : Any nonconsensual sexual act, verbal or non-verbal, isolated or repeated; any attempt by another person to perform a sexual act or any other act against the sexuality of a person using force, regardless of his or her relationship with the victim, in any context<\/p><hr \/><p>FR : Acte agressif, isol\u00e9 ou r\u00e9p\u00e9t\u00e9, perp\u00e9tr\u00e9 au moyen de m\u00e9dias num\u00e9riques (p. ex. texto, Internet, r\u00e9seaux sociaux, etc.), qui vise \u00e0 blesser, d\u00e9nigrer ou contr\u00f4ler autrui | EN : Aggressive, isolated or repeated act, perpetrated using digital media (e.g. text messages, internet, social networks, etc.) to hurt, denigrate or control others<\/p><hr \/><p>FR : Absence ou manque important de r\u00e9ponse aux besoins d\u2019une personne \u00e0 charge | EN : Failure or significant lack of response to a dependent\u2019s needs<\/p><hr \/><p>FR : Attitude, parole ou geste qui vise \u00e0 d\u00e9nigrer ou contr\u00f4ler les croyances d\u2019une autre personne | EN : Attitude, speech or gesture that is intended to denigrate or control the beliefs of another person<\/p><hr \/><p>FR : Acte qui vise \u00e0 restreindre l\u2019autonomie financi\u00e8re d\u2019une autre personne pour mieux la contr\u00f4ler | EN : Act that seeks to restrict another person\u2019s financial autonomy in order to better control them<\/p><hr \/><p>FR : Violence cr\u00e9e par les dynamiques de pouvoir qui existent au sein de notre soci\u00e9t\u00e9 et qui sont reproduites aux niveaux institutionnel, structurel et interpersonnel (p. ex. domaines du logement, de l\u2019emploi, de la sant\u00e9, de la justice, etc.) | EN : Violence created by power dynamics that exist within our society and are replicated at the institutional, structural and interpersonal levels (e.g., housing, employment, health, justice, etc.)<\/p><\/div><\/fieldset><div id=\"field_2_36\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Psychological or verbal <\/h3><\/div><fieldset id=\"field_2_34\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Select the violent behaviour(s) you have witnessed <\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_34'><div class='gchoice gchoice_2_34_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.1' type='checkbox'  value='Des insultes'  id='choice_2_34_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_34_1' id='label_2_34_1' class='gform-field-label gform-field-label--type-inline'>Insulted<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_34_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.2' type='checkbox'  value='Des menaces'  id='choice_2_34_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_34_2' id='label_2_34_2' class='gform-field-label gform-field-label--type-inline'>Threatened<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_34_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.3' type='checkbox'  value='Des mensonges'  id='choice_2_34_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_34_3' id='label_2_34_3' class='gform-field-label gform-field-label--type-inline'>Lied to<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_34_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.4' type='checkbox'  value='Des critiques incessantes'  id='choice_2_34_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_34_4' id='label_2_34_4' class='gform-field-label gform-field-label--type-inline'>Criticized incessantly<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_34_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.5' type='checkbox'  value='Du contr\u00f4le coercitif'  id='choice_2_34_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_34_5' id='label_2_34_5' class='gform-field-label gform-field-label--type-inline'>Coercitive control<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_34_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.6' type='checkbox'  value='Du m\u00e9genrage'  id='choice_2_34_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_34_6' id='label_2_34_6' class='gform-field-label gform-field-label--type-inline'>Being misgendered or deadnamed<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_34_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.7' type='checkbox'  value='De la d\u00e9valorisation'  id='choice_2_34_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_34_7' id='label_2_34_7' class='gform-field-label gform-field-label--type-inline'>Being devalued, denigrated or belittled<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_34_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.8' type='checkbox'  value='De la manipulation'  id='choice_2_34_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_34_8' id='label_2_34_8' class='gform-field-label gform-field-label--type-inline'>Being manipulated<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_34_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.9' type='checkbox'  value='De l\u2019intimidation'  id='choice_2_34_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_34_9' id='label_2_34_9' class='gform-field-label gform-field-label--type-inline'>Being intimidated<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_34_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.11' type='checkbox'  value='De l\u2019humiliation'  id='choice_2_34_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_34_11' id='label_2_34_11' class='gform-field-label gform-field-label--type-inline'>Being humiliated<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_34_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.12' type='checkbox'  value='De l\u2019invalidation'  id='choice_2_34_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_34_12' id='label_2_34_12' class='gform-field-label gform-field-label--type-inline'>Being invalidated<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_34_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.13' type='checkbox'  value='De l\u2019infantilisation'  id='choice_2_34_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_34_13' id='label_2_34_13' class='gform-field-label gform-field-label--type-inline'>Being infantilized<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_34_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.14' type='checkbox'  value='Un isolement social forc\u00e9'  id='choice_2_34_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_34_14' id='label_2_34_14' class='gform-field-label gform-field-label--type-inline'>Social isolation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_34_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.15' type='checkbox'  value='Un d\u00e9voilement non consenti de sa situation ou son identit\u00e9'  id='choice_2_34_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_34_15' id='label_2_34_15' class='gform-field-label gform-field-label--type-inline'>Being threatened with or revealing sensitive information<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_34_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.16' type='checkbox'  value='Autre(s) (pr\u00e9ciser)'  id='choice_2_34_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_34_16' id='label_2_34_16' class='gform-field-label gform-field-label--type-inline'>Other(s) (Please specify)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='mm_tooltip_text' style='display:none'><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><p>FR : M\u00e9genrage &#8211; lorsqu\u2019une personne ne respecte pas les pronoms et accords d\u2019une autre personne (p. ex. dire d\u2019une femme \u00ab il est attachant \u00bb plut\u00f4t que \u00ab elle est attachante \u00bb) | EN : Misgendering &#8211; when someone doesn&#8217;t respect someone&#8217;s pronouns or gendered terms (i.e. Mister\/Miss, He\/she\/they, etc.)\u00a0<\/p><hr \/><hr \/><hr \/><hr \/><hr \/><p>FR : Invalidation &#8211; lorsqu\u2019une personne ignore, rejette ou juge les \u00e9motions d\u2019une autre personne, ou impose sa vision des \u00e9motions, du v\u00e9cu ou de l\u2019identit\u00e9 d\u2019une autre personne (p. ex. ne pas croire une personne lorsqu\u2019elle fait son coming out) | EN : Invalidation &#8211; when someone ignores, rejects or judges another person\u2019s emotions, or imposes their view of the emotions, experiences or identity of another person (e.g., not believing a person when they come out)<\/p><hr \/><p>FR : Infantilisation &#8211; lorsqu\u2019une personne se positionne comme sup\u00e9rieure dans le but de d\u00e9valoriser les connaissances, les aptitudes ou les exp\u00e9riences de l\u2019autre (p. ex. dire \u00e0 une personne lesbienne qu\u2019elle finira par reconna\u00eetre les autres femmes lesbiennes quand elle aura assez d\u2019exp\u00e9rience) | EN : Infantilization: when a person positions themself as superior in order to devalue the knowledge, skills or experiences of the other (e.g. tell a lesbian that she will recognize other lesbian women when she has enough experience)<\/p><hr \/><p>FR : Par exemple, lorsqu\u2019une personne emp\u00eache l\u2019autre de voir ou de parler \u00e0 sa famille | EN : For example when someone keep another person from seeing their friends and family.<\/p><hr \/><p>FR : Par exemple, lorsqu\u2019une personne d\u00e9voile l\u2019identit\u00e9 LGBTQI+ ou le statut s\u00e9rologique d\u2019une autre personne sans son consentement | EN : For example, when someone outs someone else as being LGBTQ+.<\/p><\/div><\/fieldset><div id=\"field_2_35\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_35'>Other(s)<\/label><div class='ginput_container ginput_container_text'><input name='input_35' id='input_2_35' type='text' value='' class='large' maxlength='350'     aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_37\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Physical<\/h3><\/div><fieldset id=\"field_2_38\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Select the violent behaviour(s) you have witnessed <\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_38'><div class='gchoice gchoice_2_38_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.1' type='checkbox'  value='Un pincement'  id='choice_2_38_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_38_1' id='label_2_38_1' class='gform-field-label gform-field-label--type-inline'>Pinched<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_38_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.2' type='checkbox'  value='Une pouss\u00e9e ou une bousculade'  id='choice_2_38_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_38_2' id='label_2_38_2' class='gform-field-label gform-field-label--type-inline'>Pushed or shoved<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_38_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.3' type='checkbox'  value='Une gifle'  id='choice_2_38_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_38_3' id='label_2_38_3' class='gform-field-label gform-field-label--type-inline'>Slapped<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_38_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.4' type='checkbox'  value='Une br\u00fblure'  id='choice_2_38_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_38_4' id='label_2_38_4' class='gform-field-label gform-field-label--type-inline'>Burned<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_38_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.5' type='checkbox'  value='Un coup de poing ou de pied'  id='choice_2_38_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_38_5' id='label_2_38_5' class='gform-field-label gform-field-label--type-inline'>Hit<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_38_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.6' type='checkbox'  value='La restriction de ses mouvements, ou on a bloqu\u00e9 son chemin'  id='choice_2_38_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_38_6' id='label_2_38_6' class='gform-field-label gform-field-label--type-inline'>Being restricted in movements or someone blocking your way<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_38_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.7' type='checkbox'  value='Un \u00e9tranglement ou la restriction de ses voies respiratoires'  id='choice_2_38_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_38_7' id='label_2_38_7' class='gform-field-label gform-field-label--type-inline'>Restricting your breathing or strangling<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_38_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.8' type='checkbox'  value='Une blessure par arme blanche'  id='choice_2_38_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_38_8' id='label_2_38_8' class='gform-field-label gform-field-label--type-inline'>Being stabbed<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_38_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.9' type='checkbox'  value='Une blessure par balle'  id='choice_2_38_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_38_9' id='label_2_38_9' class='gform-field-label gform-field-label--type-inline'>Being shot<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_38_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.11' type='checkbox'  value='Une menace de blessure physique'  id='choice_2_38_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_38_11' id='label_2_38_11' class='gform-field-label gform-field-label--type-inline'>Being threatened of injury<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_38_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.12' type='checkbox'  value='De la pression physique \u00e0 consommer de l\u2019alcool ou de la drogue'  id='choice_2_38_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_38_12' id='label_2_38_12' class='gform-field-label gform-field-label--type-inline'>Being drugged or forced to drink, or pressured to<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_38_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.13' type='checkbox'  value='Une sc\u00e8ne de violence envers un objet'  id='choice_2_38_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_38_13' id='label_2_38_13' class='gform-field-label gform-field-label--type-inline'>Being the target of thrown objects, seeing objects being thrown or damaged<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_38_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.14' type='checkbox'  value='Une tentative de meurtre'  id='choice_2_38_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_38_14' id='label_2_38_14' class='gform-field-label gform-field-label--type-inline'>Being victim of attempted murder<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_38_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.15' type='checkbox'  value='Autre(s) (pr\u00e9ciser)'  id='choice_2_38_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_38_15' id='label_2_38_15' class='gform-field-label gform-field-label--type-inline'>Other(s) (Please specify)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_39\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_39'>Other(s)<\/label><div class='ginput_container ginput_container_text'><input name='input_39' id='input_2_39' type='text' value='' class='large' maxlength='350'     aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_41\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Sexual<\/h3><\/div><fieldset id=\"field_2_42\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Select the violent behaviour(s) you have witnessed <\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_42'><div class='gchoice gchoice_2_42_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.1' type='checkbox'  value='Une remarque \u00e0 caract\u00e8re sexuel non d\u00e9sir\u00e9e'  id='choice_2_42_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_42_1' id='label_2_42_1' class='gform-field-label gform-field-label--type-inline'>Receiving sexual comments, or unwanted comments on your body<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_42_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.2' type='checkbox'  value='Un attouchement non d\u00e9sir\u00e9'  id='choice_2_42_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_42_2' id='label_2_42_2' class='gform-field-label gform-field-label--type-inline'>Touched without their consent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_42_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.3' type='checkbox'  value='Du harc\u00e8lement sexuel'  id='choice_2_42_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_42_3' id='label_2_42_3' class='gform-field-label gform-field-label--type-inline'>Sexually harassed<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_42_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.4' type='checkbox'  value='Une pression \u00e0 toucher'  id='choice_2_42_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_42_4' id='label_2_42_4' class='gform-field-label gform-field-label--type-inline'>Pressured or forced to touch someone<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_42_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.5' type='checkbox'  value='Une pression \u00e0 avoir un rapport sexuel'  id='choice_2_42_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_42_5' id='label_2_42_5' class='gform-field-label gform-field-label--type-inline'>Pressured or forced to have sexual relations<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_42_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.6' type='checkbox'  value='Une pression \u00e0 avoir certaines pratiques sexuelles'  id='choice_2_42_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_42_6' id='label_2_42_6' class='gform-field-label gform-field-label--type-inline'>Pressured or forced to have certain sexual practices<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_42_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.7' type='checkbox'  value='Des questions intrusives, par exemple \u00e0 propos de ses organes g\u00e9nitaux'  id='choice_2_42_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_42_7' id='label_2_42_7' class='gform-field-label gform-field-label--type-inline'>Being asked intrusive questions (ex. about their genitalia)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_42_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.8' type='checkbox'  value='Une pression \u00e0 regarder des images sexuellement explicites'  id='choice_2_42_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_42_8' id='label_2_42_8' class='gform-field-label gform-field-label--type-inline'>Being forced or compelled to look at sexually explicit images<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_42_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.9' type='checkbox'  value='Une pression \u00e0 produire des images sexuellement explicites'  id='choice_2_42_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_42_9' id='label_2_42_9' class='gform-field-label gform-field-label--type-inline'>Being forced or compelled to produce sexually explicit images<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_42_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.11' type='checkbox'  value='Le partage d&#039;images intimes de sa personne \u00e0 d&#039;autres sans son consentement'  id='choice_2_42_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_42_11' id='label_2_42_11' class='gform-field-label gform-field-label--type-inline'>Having intimate personal images being shared with other people without their consent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_42_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.12' type='checkbox'  value='Une pression \u00e0 avoir un rapport sexuel sans moyen de protection'  id='choice_2_42_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_42_12' id='label_2_42_12' class='gform-field-label gform-field-label--type-inline'>Being forced to have sexual intercourse without means of protection<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_42_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.13' type='checkbox'  value='De la manipulation dans le but d\u2019influencer le consentement'  id='choice_2_42_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_42_13' id='label_2_42_13' class='gform-field-label gform-field-label--type-inline'>Being manipulated in order to influence consent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_42_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.14' type='checkbox'  value='Le non-d\u00e9voilement d\u2019une infection transmissible sexuellement ou par le sang lorsqu\u2019il y a possibilit\u00e9 de transmission'  id='choice_2_42_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_42_14' id='label_2_42_14' class='gform-field-label gform-field-label--type-inline'>Being intentionally exposed to a sexually transmitted or blood-borne infection without their knowledge or consent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_42_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.15' type='checkbox'  value='Le retrait non consenti du moyen de protection pendant un rapport sexuel'  id='choice_2_42_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_42_15' id='label_2_42_15' class='gform-field-label gform-field-label--type-inline'>Having the protection being removed without consent (ex. stealthing)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_42_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.16' type='checkbox'  value='Autre(s) (pr\u00e9ciser)'  id='choice_2_42_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_42_16' id='label_2_42_16' class='gform-field-label gform-field-label--type-inline'>Other(s) (Please specify)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_43\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_43'>Other(s)<\/label><div class='ginput_container ginput_container_text'><input name='input_43' id='input_2_43' type='text' value='' class='large' maxlength='350'     aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_44\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Cyberviolence<\/h3><\/div><fieldset id=\"field_2_46\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Select the violent behaviour(s) you have witnessed <\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_46'><div class='gchoice gchoice_2_46_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.1' type='checkbox'  value='Le vol de son identit\u00e9 ou de ses mots de passe'  id='choice_2_46_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_46_1' id='label_2_46_1' class='gform-field-label gform-field-label--type-inline'>Having their identity or password stolen<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_46_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.2' type='checkbox'  value='Une atteinte \u00e0 sa r\u00e9putation ou de la diffamation en ligne'  id='choice_2_46_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_46_2' id='label_2_46_2' class='gform-field-label gform-field-label--type-inline'>Having their reputation damaged online<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_46_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.3' type='checkbox'  value='Des propos haineux'  id='choice_2_46_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_46_3' id='label_2_46_3' class='gform-field-label gform-field-label--type-inline'>Receiving hate speech<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_46_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.4' type='checkbox'  value='Des menaces'  id='choice_2_46_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_46_4' id='label_2_46_4' class='gform-field-label gform-field-label--type-inline'>Receiving threats online<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_46_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.5' type='checkbox'  value='L&#039;exposition \u00e0 des messages, des images ou contenus haineux envers les communaut\u00e9s LGBTQ+'  id='choice_2_46_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_46_5' id='label_2_46_5' class='gform-field-label gform-field-label--type-inline'>Seeing messages or images that are hateful to the LGBTQ+ communities<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_46_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.6' type='checkbox'  value='De la surveillance ou de l\u2019espionnage'  id='choice_2_46_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_46_6' id='label_2_46_6' class='gform-field-label gform-field-label--type-inline'>Being watched or spied on<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_46_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.7' type='checkbox'  value='La propagation de rumeurs \u00e0 son \u00e9gard'  id='choice_2_46_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_46_7' id='label_2_46_7' class='gform-field-label gform-field-label--type-inline'>Having a speech about them circulated without their consent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_46_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.8' type='checkbox'  value='La publication ou le partage non consenti(e) de photos ou de vid\u00e9os ou la personne appara\u00eet'  id='choice_2_46_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_46_8' id='label_2_46_8' class='gform-field-label gform-field-label--type-inline'>Having a video or photo, sexually explicit or not, shared or recorded without their consent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_46_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.9' type='checkbox'  value='La divulgation non consentie d&#039;informations sur sa vie priv\u00e9e'  id='choice_2_46_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_46_9' id='label_2_46_9' class='gform-field-label gform-field-label--type-inline'>Having their personal information seen or shared without their consent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_46_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.11' type='checkbox'  value='La consultation non consentie de ses conversations priv\u00e9es'  id='choice_2_46_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_46_11' id='label_2_46_11' class='gform-field-label gform-field-label--type-inline'>Having their private messages seen or shared without their consent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_46_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.12' type='checkbox'  value='Une pression \u00e0 r\u00e9v\u00e9ler des informations priv\u00e9es'  id='choice_2_46_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_46_12' id='label_2_46_12' class='gform-field-label gform-field-label--type-inline'>Being pressured into sharing their personal informations online<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_46_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.13' type='checkbox'  value='Le non-respect de son identit\u00e9, ou on lui a demand\u00e9 des documents excessifs \u00e0 propos de son identit\u00e9'  id='choice_2_46_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_46_13' id='label_2_46_13' class='gform-field-label gform-field-label--type-inline'>Seeing their identity not respected or being unreasonably asked for documentation regarding their identity<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_46_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.14' type='checkbox'  value='La perte d&#039;acc\u00e8s \u00e0 un compte \u00e0 cause des r\u00e8gles du site ou de l&#039;application concernant son identit\u00e9'  id='choice_2_46_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_46_14' id='label_2_46_14' class='gform-field-label gform-field-label--type-inline'>Losing access to their account because of the rules of a web site regarding their identity<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_46_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.15' type='checkbox'  value='Une censure de ses contenus publi\u00e9s sur les r\u00e9seaux sociaux'  id='choice_2_46_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_46_15' id='label_2_46_15' class='gform-field-label gform-field-label--type-inline'>Having the content they post online being censored because it was about LGBTQ+ topics<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_46_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.16' type='checkbox'  value='Autre(s) (pr\u00e9ciser)'  id='choice_2_46_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_46_16' id='label_2_46_16' class='gform-field-label gform-field-label--type-inline'>Other(s) (Please specify)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_47\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_47'>Other(s)<\/label><div class='ginput_container ginput_container_text'><input name='input_47' id='input_2_47' type='text' value='' class='large' maxlength='350'     aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_48\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Negligence<\/h3><\/div><fieldset id=\"field_2_49\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Select the violent behaviour(s) you have witnessed <\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_49'><div class='gchoice gchoice_2_49_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.1' type='checkbox'  value='La n\u00e9gligence de son alimentation'  id='choice_2_49_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_49_1' id='label_2_49_1' class='gform-field-label gform-field-label--type-inline'>Someone neglecting to properly feed them as a dependent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_49_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.2' type='checkbox'  value='La n\u00e9gligence d&#039;offrir un logement ad\u00e9quat'  id='choice_2_49_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_49_2' id='label_2_49_2' class='gform-field-label gform-field-label--type-inline'>Someone neglecting to provide housing to them as a dependent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_49_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.3' type='checkbox'  value='La n\u00e9gligence de fournir l\u2019habillement requis'  id='choice_2_49_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_49_3' id='label_2_49_3' class='gform-field-label gform-field-label--type-inline'>Someone neglecting to provide adequate clothing to them as a dependent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_49_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.4' type='checkbox'  value='La n\u00e9gligence de lui fournir les m\u00e9dicaments requis'  id='choice_2_49_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_49_4' id='label_2_49_4' class='gform-field-label gform-field-label--type-inline'>Someone neglecting to provide the necessary medication they needed as a dependent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_49_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.5' type='checkbox'  value='La n\u00e9gligence de lui fournir les soins de sant\u00e9 requis'  id='choice_2_49_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_49_5' id='label_2_49_5' class='gform-field-label gform-field-label--type-inline'>Someone neglecting to provide the necessary health care they needed as a dependent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_49_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.6' type='checkbox'  value='La n\u00e9gligence de lui offrir une supervision ad\u00e9quate ou d&#039;assurer sa s\u00e9curit\u00e9'  id='choice_2_49_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_49_6' id='label_2_49_6' class='gform-field-label gform-field-label--type-inline'>Someone neglecting their safety as a dependent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_49_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.7' type='checkbox'  value='La n\u00e9gligence de ses besoins sociaux et affectifs'  id='choice_2_49_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_49_7' id='label_2_49_7' class='gform-field-label gform-field-label--type-inline'>Someone neglecting to answer to their emotional or social needs as a dependent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_49_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.8' type='checkbox'  value='Autre(s) (pr\u00e9ciser)'  id='choice_2_49_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_49_8' id='label_2_49_8' class='gform-field-label gform-field-label--type-inline'>Other(s) (Please specify)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_50\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_50'>Other(s)<\/label><div class='ginput_container ginput_container_text'><input name='input_50' id='input_2_50' type='text' value='' class='large' maxlength='350'     aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_51\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Religious or spiritual abuse<\/h3><\/div><fieldset id=\"field_2_52\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Select the violent behaviour(s) you have witnessed <\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_52'><div class='gchoice gchoice_2_52_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.1' type='checkbox'  value='Une exclusion ou menace d\u2019exclusion d\u2019une communaut\u00e9 religieuse ou spirituelle en raison de son orientation sexuelle ou son identit\u00e9 de genre'  id='choice_2_52_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_52_1' id='label_2_52_1' class='gform-field-label gform-field-label--type-inline'>Excluded or threatened to be excluded from a religious or spiritual community because of their sexual orientation or gender identity <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_52_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.2' type='checkbox'  value='Une exclusion ou menace d\u2019exclusion d\u2019un groupe ou d\u2019une activit\u00e9 LGBTQI+ en raison de ses croyances religieuses ou spirituelles'  id='choice_2_52_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_52_2' id='label_2_52_2' class='gform-field-label gform-field-label--type-inline'>Excluded or threatened to be excluded from a LGBTQI+ group or activity because of their religious or spiritual beliefs  <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_52_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.3' type='checkbox'  value='Un mariage forc\u00e9'  id='choice_2_52_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_52_3' id='label_2_52_3' class='gform-field-label gform-field-label--type-inline'>In a forced marriage<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_52_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.4' type='checkbox'  value='Une interdiction de mariage'  id='choice_2_52_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_52_4' id='label_2_52_4' class='gform-field-label gform-field-label--type-inline'>Forbidden to marry<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_52_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.5' type='checkbox'  value='Un d\u00e9nigrement de ses croyances religieuses ou spirituelles'  id='choice_2_52_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_52_5' id='label_2_52_5' class='gform-field-label gform-field-label--type-inline'>Denigrated because of their religious or spiritual beliefs <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_52_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.6' type='checkbox'  value='Un d\u00e9nigrement de son identit\u00e9 LGBTQ+ via l&#039;utilisation de croyances religieuses ou spirituelles'  id='choice_2_52_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_52_6' id='label_2_52_6' class='gform-field-label gform-field-label--type-inline'>Being belittled, discriminated against or threatened, as an LGBTQ+ person by using religious or spiritual beliefs<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_52_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.7' type='checkbox'  value='Une interdiction d\u2019exprimer ses croyances religieuses ou spirituelles'  id='choice_2_52_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_52_7' id='label_2_52_7' class='gform-field-label gform-field-label--type-inline'>Being prevented from practicing religion or chosen spirituality<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_52_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.8' type='checkbox'  value='Une obligation \u00e0 pratiquer une religion ou \u00e0 adopter des pratiques spirituelles'  id='choice_2_52_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_52_8' id='label_2_52_8' class='gform-field-label gform-field-label--type-inline'>Being forced to practice a religion or to make a spiritual journey<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_52_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.9' type='checkbox'  value='Autre(s) (pr\u00e9ciser)'  id='choice_2_52_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_52_9' id='label_2_52_9' class='gform-field-label gform-field-label--type-inline'>Other(s) (Please specify)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_53\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_53'>Other(s)<\/label><div class='ginput_container ginput_container_text'><input name='input_53' id='input_2_53' type='text' value='' class='large' maxlength='350'     aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_54\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Financial<\/h3><\/div><fieldset id=\"field_2_55\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Select the violent behaviour(s) you have witnessed <\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_55'><div class='gchoice gchoice_2_55_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_55.1' type='checkbox'  value='Une prise de contr\u00f4le sur ses \u00e9tudes ou son travail'  id='choice_2_55_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_55_1' id='label_2_55_1' class='gform-field-label gform-field-label--type-inline'>Control over their studies or work  <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_55_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_55.2' type='checkbox'  value='Une prise de contr\u00f4le sur ses revenus'  id='choice_2_55_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_55_2' id='label_2_55_2' class='gform-field-label gform-field-label--type-inline'>Control over their income <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_55_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_55.3' type='checkbox'  value='Une prise de contr\u00f4le sur ses d\u00e9penses'  id='choice_2_55_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_55_3' id='label_2_55_3' class='gform-field-label gform-field-label--type-inline'>Control over their expenses<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_55_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_55.4' type='checkbox'  value='Une fraude ou tentative de fraude'  id='choice_2_55_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_55_4' id='label_2_55_4' class='gform-field-label gform-field-label--type-inline'>Fraud or attempted fraud<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_55_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_55.5' type='checkbox'  value='Un vol d\u2019identit\u00e9'  id='choice_2_55_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_55_5' id='label_2_55_5' class='gform-field-label gform-field-label--type-inline'>Identity theft<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_55_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_55.6' type='checkbox'  value='Une pression \u00e0 s\u2019endetter'  id='choice_2_55_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_55_6' id='label_2_55_6' class='gform-field-label gform-field-label--type-inline'>Pressure to be in debt <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_55_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_55.7' type='checkbox'  value='Une interdiction d\u2019achats essentiels'  id='choice_2_55_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_55_7' id='label_2_55_7' class='gform-field-label gform-field-label--type-inline'>Not being allowed to buy essential things<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_55_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_55.8' type='checkbox'  value='Une obligation \u00e0 voler ou frauder'  id='choice_2_55_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_55_8' id='label_2_55_8' class='gform-field-label gform-field-label--type-inline'>An obligation to steal or defraud<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_55_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_55.9' type='checkbox'  value='La d\u00e9t\u00e9rioration ou destruction de mes biens'  id='choice_2_55_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_55_9' id='label_2_55_9' class='gform-field-label gform-field-label--type-inline'>The destruction or damage of their things <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_55_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_55.11' type='checkbox'  value='Un vol'  id='choice_2_55_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_55_11' id='label_2_55_11' class='gform-field-label gform-field-label--type-inline'>A theft<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_55_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_55.12' type='checkbox'  value='Une introduction par effraction'  id='choice_2_55_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_55_12' id='label_2_55_12' class='gform-field-label gform-field-label--type-inline'>Breaking and entering <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_55_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_55.13' type='checkbox'  value='Une incitation ou pression \u00e0 effectuer certains achats.'  id='choice_2_55_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_55_13' id='label_2_55_13' class='gform-field-label gform-field-label--type-inline'>Pressure to buy certain things. <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_55_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_55.14' type='checkbox'  value='Autres (pr\u00e9ciser)'  id='choice_2_55_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_55_14' id='label_2_55_14' class='gform-field-label gform-field-label--type-inline'>Other(s) (Please specify)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='mm_tooltip_text' style='display:none'><hr \/><hr \/><hr \/><hr \/><p>FR : Par exemple, utiliser la carte de cr\u00e9dit d\u2019une autre personne sans son consentement | EN : For example, using someone else&#8217;s credit card without their consent<\/p><\/div><\/fieldset><div id=\"field_2_56\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_56'>Other(s)<\/label><div class='ginput_container ginput_container_text'><input name='input_56' id='input_2_56' type='text' value='' class='large' maxlength='350'     aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_57\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Systemic<\/h3><\/div><fieldset id=\"field_2_58\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Select the violent behaviour(s) you have witnessed <\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_58'><div class='gchoice gchoice_2_58_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.1' type='checkbox'  value='Un refus d\u2019acc\u00e8s \u00e0 un emploi'  id='choice_2_58_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_58_1' id='label_2_58_1' class='gform-field-label gform-field-label--type-inline'>Refused access to employment<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_58_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.2' type='checkbox'  value='Un refus d\u2019acc\u00e8s \u00e0 un logement'  id='choice_2_58_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_58_2' id='label_2_58_2' class='gform-field-label gform-field-label--type-inline'>Refused access to housing<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_58_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.3' type='checkbox'  value='Un refus d\u2019acc\u00e8s \u00e0 un service priv\u00e9'  id='choice_2_58_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_58_3' id='label_2_58_3' class='gform-field-label gform-field-label--type-inline'>Refused access to private services<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_58_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.4' type='checkbox'  value='Un refus d\u2019acc\u00e8s \u00e0 un service public'  id='choice_2_58_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_58_4' id='label_2_58_4' class='gform-field-label gform-field-label--type-inline'>Refused access to public services<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_58_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.5' type='checkbox'  value='Un refus d\u2019acc\u00e8s \u00e0 un traitement'  id='choice_2_58_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_58_5' id='label_2_58_5' class='gform-field-label gform-field-label--type-inline'>Refused access to treatments<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_58_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.6' type='checkbox'  value='Une pression ou obligation \u00e0 recourir \u00e0 un traitement'  id='choice_2_58_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_58_6' id='label_2_58_6' class='gform-field-label gform-field-label--type-inline'>Pressured or obligated to take a treatment<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_58_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.7' type='checkbox'  value='Un refus d\u2019acc\u00e8s \u00e0 un lieu'  id='choice_2_58_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_58_7' id='label_2_58_7' class='gform-field-label gform-field-label--type-inline'>Refused access to a place<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_58_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.8' type='checkbox'  value='Une n\u00e9gligence ou un non-respect de ses droits humains'  id='choice_2_58_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_58_8' id='label_2_58_8' class='gform-field-label gform-field-label--type-inline'>Neglect or disrespect of their human rights<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_58_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.9' type='checkbox'  value='Une invisibilisation'  id='choice_2_58_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_58_9' id='label_2_58_9' class='gform-field-label gform-field-label--type-inline'>Invisibilized<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_58_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.11' type='checkbox'  value='De la discrimination en raison de son identit\u00e9 ou de son apparence'  id='choice_2_58_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_58_11' id='label_2_58_11' class='gform-field-label gform-field-label--type-inline'>Discriminated against because of their identity or their appearance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_58_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.12' type='checkbox'  value='Un service de moindre qualit\u00e9 en raison de son identit\u00e9 (ethnoculturelle, sexuelle, de genre, etc.) ou de son apparence'  id='choice_2_58_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_58_12' id='label_2_58_12' class='gform-field-label gform-field-label--type-inline'>Given a lesser service because of their identity or their appearance <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_58_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.13' type='checkbox'  value='Une loi discriminatoire (pr\u00e9ciser)'  id='choice_2_58_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_58_13' id='label_2_58_13' class='gform-field-label gform-field-label--type-inline'>A discriminatory law (Please specify)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_58_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.14' type='checkbox'  value='Autre(s) (pr\u00e9ciser)'  id='choice_2_58_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_58_14' id='label_2_58_14' class='gform-field-label gform-field-label--type-inline'>Other(s) (Please specify)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='mm_tooltip_text' style='display:none'><hr \/><hr \/><hr \/><hr \/><hr \/><p>FR : Par exemple, m\u00e9dicaments anti-VIH, hormones, hospitalisation, etc. | EN : For example, anti-HIV medications, hormones, hospital stay, etc.\u00a0<\/p><hr \/><p>FR : Par exemple, st\u00e9rilisation forc\u00e9e, chirurgie non consentie, th\u00e9rapie de conversion, etc. | EN : For example, forced sterilization, unconsented surgery, conversion therapy, etc.<\/p><hr \/><p>FR : Par exemple, vestiaires, toilettes, etc. | EN : For example bathrooms, changing rooms,\u00a0 etc.<\/p><hr \/><p>FR : Par exemple, traitement d\u00e9favorable sur la base d\u2019un motif de discrimination interdit par la Charte des droits et libert\u00e9s (p. ex. \u00e2ge, sexe, identit\u00e9 de genre, orientation sexuelle, etc.) | EN : For example, Unfavourable treatment on the basis of a ground of discrimination prohibited by the Charter of Rights and Freedoms (e.g. age, gender, gender identity, sexual orientation, etc.)<\/p><hr \/><p>FR : Par exemple, un formulaire ne reconnaissant que le mod\u00e8le familial h\u00e9t\u00e9rosexuel | EN : For example, a form that recognizes only the heterosexual family model<\/p><\/div><\/fieldset><div id=\"field_2_149\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_149'>A discriminatory law<\/label><div class='ginput_container ginput_container_text'><input name='input_149' id='input_2_149' type='text' value='' class='large' maxlength='350'     aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_59\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_59'>Other(s)<\/label><div class='ginput_container ginput_container_text'><input name='input_59' id='input_2_59' type='text' value='' class='large' maxlength='350'     aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_2_60' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Back'  \/> <input type='button' id='gform_next_button_2_60' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_2_3' class='gform_page' data-js='page-field-id-60' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_2_3' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_2_61\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">3. FREQUENCY<\/h3><\/div><div id=\"field_2_62\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Was the violence you have witnessed an isolated situation or one that lasted?*<\/h3><\/div><fieldset id=\"field_2_63\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >3T &#8211; Situation isol\u00e9e ou durable<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_2_63'>\n\t\t\t<div class='gchoice gchoice_2_63_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_63' type='radio' value='Situation isol\u00e9e'  id='choice_2_63_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_63_0' id='label_2_63_0' class='gform-field-label gform-field-label--type-inline'>Isolated situation<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_63_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_63' type='radio' value='Situation durable'  id='choice_2_63_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_63_1' id='label_2_63_1' class='gform-field-label gform-field-label--type-inline'>Extended situation<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_65\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">When did this event occur? <\/h3><\/div><div id=\"field_2_67\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_67'>Year<\/label><div class='ginput_container ginput_container_select'><select name='input_67' id='input_2_67' class='large gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='2030' >2030<\/option><option value='2029' >2029<\/option><option value='2028' >2028<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><option value='1919' >1919<\/option><option value='1918' >1918<\/option><option value='1917' >1917<\/option><option value='1916' >1916<\/option><option value='1915' >1915<\/option><option value='1914' >1914<\/option><option value='1913' >1913<\/option><option value='1912' >1912<\/option><option value='1911' >1911<\/option><option value='1910' >1910<\/option><option value='1909' >1909<\/option><option value='1908' >1908<\/option><option value='1907' >1907<\/option><option value='1906' >1906<\/option><option value='1905' >1905<\/option><option value='1904' >1904<\/option><option value='1903' >1903<\/option><option value='1902' >1902<\/option><option value='1901' >1901<\/option><option value='1900' >1900<\/option><\/select><\/div><\/div><fieldset id=\"field_2_140\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >3T &#8211; Situation isol\u00e9e, ann\u00e9e<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_140'><div class='gchoice gchoice_2_140_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_140.1' type='checkbox'  value='Je pr\u00e9f\u00e8re ne pas r\u00e9pondre'  id='choice_2_140_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_140_1' id='label_2_140_1' class='gform-field-label gform-field-label--type-inline'>I prefer not to answer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_140_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_140.2' type='checkbox'  value='Je ne sais pas'  id='choice_2_140_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_140_2' id='label_2_140_2' class='gform-field-label gform-field-label--type-inline'>I do not know<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_66\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_66'>Month<\/label><div class='ginput_container ginput_container_select'><select name='input_66' id='input_2_66' class='large gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Janvier' >January<\/option><option value='F\u00e9vrier' >February<\/option><option value='Mars' >March<\/option><option value='Avril' >April<\/option><option value='Mai' >May<\/option><option value='Juin' >June<\/option><option value='Juillet' >July<\/option><option value='Ao\u00fbt' >August<\/option><option value='Septembre' >September<\/option><option value='Octobre' >October<\/option><option value='Novembre' >November<\/option><option value='D\u00e9cembre' >December<\/option><\/select><\/div><\/div><fieldset id=\"field_2_68\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >3T &#8211; Situation isol\u00e9e, mois<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_68'><div class='gchoice gchoice_2_68_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_68.1' type='checkbox'  value='Je pr\u00e9f\u00e8re ne pas r\u00e9pondre'  id='choice_2_68_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_68_1' id='label_2_68_1' class='gform-field-label gform-field-label--type-inline'>I prefer not to answer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_68_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_68.2' type='checkbox'  value='Je ne sais pas'  id='choice_2_68_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_68_2' id='label_2_68_2' class='gform-field-label gform-field-label--type-inline'>I do not know<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_69\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">During what time of the day did it occur? <\/h3><\/div><fieldset id=\"field_2_70\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >3T &#8211; Situation isol\u00e9e, Moment de la journ\u00e9e<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_70'><div class='gchoice gchoice_2_70_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_70.1' type='checkbox'  value='Jour'  id='choice_2_70_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_70_1' id='label_2_70_1' class='gform-field-label gform-field-label--type-inline'>Daytime<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_70_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_70.2' type='checkbox'  value='Soir'  id='choice_2_70_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_70_2' id='label_2_70_2' class='gform-field-label gform-field-label--type-inline'>During the evening<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_70_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_70.3' type='checkbox'  value='Nuit'  id='choice_2_70_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_70_3' id='label_2_70_3' class='gform-field-label gform-field-label--type-inline'>At night<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_70_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_70.4' type='checkbox'  value='Je ne sais pas'  id='choice_2_70_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_70_4' id='label_2_70_4' class='gform-field-label gform-field-label--type-inline'>I do not know<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_70_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_70.5' type='checkbox'  value='Je pr\u00e9f\u00e8re ne pas r\u00e9pondre'  id='choice_2_70_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_70_5' id='label_2_70_5' class='gform-field-label gform-field-label--type-inline'>I prefer not to answer<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_71\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">How long did this situation last? <\/h3><\/div><fieldset id=\"field_2_74\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >3T &#8211; Situation durable, Pendant combien de temps<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_74'>\n\t\t\t<div class='gchoice gchoice_2_74_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_74' type='radio' value='Des jours'  id='choice_2_74_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_74_0' id='label_2_74_0' class='gform-field-label gform-field-label--type-inline'>Days<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_74_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_74' type='radio' value='Des semaines'  id='choice_2_74_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_74_1' id='label_2_74_1' class='gform-field-label gform-field-label--type-inline'>Weeks<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_74_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_74' type='radio' value='Des mois'  id='choice_2_74_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_74_2' id='label_2_74_2' class='gform-field-label gform-field-label--type-inline'>Months<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_74_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_74' type='radio' value='Des ann\u00e9es'  id='choice_2_74_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_74_3' id='label_2_74_3' class='gform-field-label gform-field-label--type-inline'>Years<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_74_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_74' type='radio' value='Je ne sais pas'  id='choice_2_74_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_74_4' id='label_2_74_4' class='gform-field-label gform-field-label--type-inline'>I do not know<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_73\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">When did you first witness this situation? <\/h3><\/div><div id=\"field_2_75\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_75'>Year<\/label><div class='ginput_container ginput_container_select'><select name='input_75' id='input_2_75' class='large gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='2030' >2030<\/option><option value='2029' >2029<\/option><option value='2028' >2028<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><option value='1919' >1919<\/option><option value='1918' >1918<\/option><option value='1917' >1917<\/option><option value='1916' >1916<\/option><option value='1915' >1915<\/option><option value='1914' >1914<\/option><option value='1913' >1913<\/option><option value='1912' >1912<\/option><option value='1911' >1911<\/option><option value='1910' >1910<\/option><option value='1909' >1909<\/option><option value='1908' >1908<\/option><option value='1907' >1907<\/option><option value='1906' >1906<\/option><option value='1905' >1905<\/option><option value='1904' >1904<\/option><option value='1903' >1903<\/option><option value='1902' >1902<\/option><option value='1901' >1901<\/option><option value='1900' >1900<\/option><\/select><\/div><\/div><fieldset id=\"field_2_143\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >3T &#8211; Situation durable, D\u00e9but, Quand<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_143'><div class='gchoice gchoice_2_143_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_143.1' type='checkbox'  value='Je pr\u00e9f\u00e8re ne pas r\u00e9pondre'  id='choice_2_143_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_143_1' id='label_2_143_1' class='gform-field-label gform-field-label--type-inline'>I prefer not to answer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_143_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_143.2' type='checkbox'  value='Je ne sais pas'  id='choice_2_143_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_143_2' id='label_2_143_2' class='gform-field-label gform-field-label--type-inline'>I do not know<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_76\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_76'>Month<\/label><div class='ginput_container ginput_container_select'><select name='input_76' id='input_2_76' class='large gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Janvier' >January<\/option><option value='F\u00e9vrier' >February<\/option><option value='Mars' >March<\/option><option value='Avril' >April<\/option><option value='Mai' >May<\/option><option value='Juin' >June<\/option><option value='Juillet' >July<\/option><option value='Ao\u00fbt' >August<\/option><option value='Septembre' >September<\/option><option value='Octobre' >October<\/option><option value='Novembre' >November<\/option><option value='D\u00e9cembre' >December<\/option><\/select><\/div><\/div><fieldset id=\"field_2_72\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >3T &#8211; Situation durable, D\u00e9but, Quand<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_72'><div class='gchoice gchoice_2_72_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_72.1' type='checkbox'  value='Je pr\u00e9f\u00e8re ne pas r\u00e9pondre'  id='choice_2_72_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_72_1' id='label_2_72_1' class='gform-field-label gform-field-label--type-inline'>I prefer not to answer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_72_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_72.2' type='checkbox'  value='Je ne sais pas'  id='choice_2_72_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_72_2' id='label_2_72_2' class='gform-field-label gform-field-label--type-inline'>I do not know<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_77\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Is it still ongoing?*<\/h3><\/div><fieldset id=\"field_2_78\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >3T &#8211; Situation durable, Toujours en cours?<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_2_78'>\n\t\t\t<div class='gchoice gchoice_2_78_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_78' type='radio' value='Oui'  id='choice_2_78_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_78_0' id='label_2_78_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_78_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_78' type='radio' value='Non'  id='choice_2_78_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_78_1' id='label_2_78_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_78_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_78' type='radio' value='Je ne sais pas'  id='choice_2_78_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_78_2' id='label_2_78_2' class='gform-field-label gform-field-label--type-inline'>I do not know<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_79\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">When did the violence or abuse stop?<\/h3><\/div><div id=\"field_2_80\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_80'>Year<\/label><div class='ginput_container ginput_container_select'><select name='input_80' id='input_2_80' class='large gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='2030' >2030<\/option><option value='2029' >2029<\/option><option value='2028' >2028<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><option value='1919' >1919<\/option><option value='1918' >1918<\/option><option value='1917' >1917<\/option><option value='1916' >1916<\/option><option value='1915' >1915<\/option><option value='1914' >1914<\/option><option value='1913' >1913<\/option><option value='1912' >1912<\/option><option value='1911' >1911<\/option><option value='1910' >1910<\/option><option value='1909' >1909<\/option><option value='1908' >1908<\/option><option value='1907' >1907<\/option><option value='1906' >1906<\/option><option value='1905' >1905<\/option><option value='1904' >1904<\/option><option value='1903' >1903<\/option><option value='1902' >1902<\/option><option value='1901' >1901<\/option><option value='1900' >1900<\/option><\/select><\/div><\/div><fieldset id=\"field_2_142\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >3T &#8211; Situation durable, D\u00e9but, Ann\u00e9e<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_142'><div class='gchoice gchoice_2_142_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_142.1' type='checkbox'  value='Je pr\u00e9f\u00e8re ne pas r\u00e9pondre'  id='choice_2_142_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_142_1' id='label_2_142_1' class='gform-field-label gform-field-label--type-inline'>I prefer not to answer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_142_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_142.2' type='checkbox'  value='Je ne sais pas'  id='choice_2_142_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_142_2' id='label_2_142_2' class='gform-field-label gform-field-label--type-inline'>I do not know<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_81\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_81'>Month<\/label><div class='ginput_container ginput_container_select'><select name='input_81' id='input_2_81' class='large gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Janvier' >January<\/option><option value='F\u00e9vrier' >February<\/option><option value='Mars' >March<\/option><option value='Avril' >April<\/option><option value='Mai' >May<\/option><option value='Juin' >June<\/option><option value='Juillet' >July<\/option><option value='Ao\u00fbt' >August<\/option><option value='Septembre' >September<\/option><option value='Octobre' >October<\/option><option value='Novembre' >November<\/option><option value='D\u00e9cembre' >December<\/option><\/select><\/div><\/div><fieldset id=\"field_2_82\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >3T &#8211; Situation durable, Fin, Mois<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_82'><div class='gchoice gchoice_2_82_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_82.1' type='checkbox'  value='Je pr\u00e9f\u00e8re ne pas r\u00e9pondre'  id='choice_2_82_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_82_1' id='label_2_82_1' class='gform-field-label gform-field-label--type-inline'>I prefer not to answer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_82_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_82.2' type='checkbox'  value='Je ne sais pas'  id='choice_2_82_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_82_2' id='label_2_82_2' class='gform-field-label gform-field-label--type-inline'>I do not know<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_2_117' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Back'  \/> <input type='button' id='gform_next_button_2_117' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_2_4' class='gform_page' data-js='page-field-id-117' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_2_4' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_2_83\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">4. PLACE<\/h3><\/div><div id=\"field_2_84\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Identify the places where you have witnessed the violence and abuse you&#039;re describing.*<\/h3><div class='gsection_description' id='gfield_description_2_84'>You can select more than one option.<\/div><\/div><fieldset id=\"field_2_85\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >4T &#8211; Lieu de la violence<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_2_85'><div class='gchoice gchoice_2_85_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.1' type='checkbox'  value='Chez moi'  id='choice_2_85_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_85_1' id='label_2_85_1' class='gform-field-label gform-field-label--type-inline'>At my home<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_85_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.2' type='checkbox'  value='Chez la ou les personnes victimes'  id='choice_2_85_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_85_2' id='label_2_85_2' class='gform-field-label gform-field-label--type-inline'>At the victim\u2019s or victims\u2019 home <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_85_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.3' type='checkbox'  value='Chez la ou les personne(s) auteure(s) de la violence'  id='choice_2_85_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_85_3' id='label_2_85_3' class='gform-field-label gform-field-label--type-inline'>At the perpetrator&#8217;s or perpetrators&#8217; home<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_85_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.4' type='checkbox'  value='Autre domicile priv\u00e9'  id='choice_2_85_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_85_4' id='label_2_85_4' class='gform-field-label gform-field-label--type-inline'>At another private home<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_85_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.5' type='checkbox'  value='Au t\u00e9l\u00e9phone'  id='choice_2_85_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_85_5' id='label_2_85_5' class='gform-field-label gform-field-label--type-inline'>On the phone<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_85_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.6' type='checkbox'  value='Milieu de travail'  id='choice_2_85_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_85_6' id='label_2_85_6' class='gform-field-label gform-field-label--type-inline'>Work environment<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_85_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.7' type='checkbox'  value='Internet et r\u00e9seaux sociaux (messages priv\u00e9s)'  id='choice_2_85_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_85_7' id='label_2_85_7' class='gform-field-label gform-field-label--type-inline'>Internet and social media (private messages)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_85_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.8' type='checkbox'  value='Internet et r\u00e9seaux sociaux (messages publics)'  id='choice_2_85_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_85_8' id='label_2_85_8' class='gform-field-label gform-field-label--type-inline'>Internet and social media (public messages)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_85_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.9' type='checkbox'  value='Section des commentaires d\u2019un site Web'  id='choice_2_85_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_85_9' id='label_2_85_9' class='gform-field-label gform-field-label--type-inline'>Comment section of a web site<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_85_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.11' type='checkbox'  value='Transports en commun'  id='choice_2_85_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_85_11' id='label_2_85_11' class='gform-field-label gform-field-label--type-inline'>Public transport <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_85_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.12' type='checkbox'  value='Rue ou parc'  id='choice_2_85_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_85_12' id='label_2_85_12' class='gform-field-label gform-field-label--type-inline'>Street or park<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_85_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.13' type='checkbox'  value='Commerce'  id='choice_2_85_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_85_13' id='label_2_85_13' class='gform-field-label gform-field-label--type-inline'>Store<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_85_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.14' type='checkbox'  value='\u00c9tablissement d\u2019enseignement'  id='choice_2_85_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_85_14' id='label_2_85_14' class='gform-field-label gform-field-label--type-inline'>Educational institution<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_85_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.15' type='checkbox'  value='H\u00f4pital'  id='choice_2_85_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_85_15' id='label_2_85_15' class='gform-field-label gform-field-label--type-inline'>Hospital<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_85_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.16' type='checkbox'  value='CLSC, CISSS, CIUSSS, CHSLD'  id='choice_2_85_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_85_16' id='label_2_85_16' class='gform-field-label gform-field-label--type-inline'>CLSC, CISSS, CIUSSS, CHSLD<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_85_17'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.17' type='checkbox'  value='Ressource d\u2019h\u00e9bergement'  id='choice_2_85_17'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_85_17' id='label_2_85_17' class='gform-field-label gform-field-label--type-inline'>Accommodation resource<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_85_18'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.18' type='checkbox'  value='Ressource communautaire'  id='choice_2_85_18'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_85_18' id='label_2_85_18' class='gform-field-label gform-field-label--type-inline'>Community resource<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_85_19'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.19' type='checkbox'  value='Prison ou p\u00e9nitencier'  id='choice_2_85_19'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_85_19' id='label_2_85_19' class='gform-field-label gform-field-label--type-inline'>Prison or penitentiary <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_85_21'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.21' type='checkbox'  value='Poste de police'  id='choice_2_85_21'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_85_21' id='label_2_85_21' class='gform-field-label gform-field-label--type-inline'>Police station<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_85_22'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.22' type='checkbox'  value='Base militaire'  id='choice_2_85_22'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_85_22' id='label_2_85_22' class='gform-field-label gform-field-label--type-inline'>Military institution <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_85_23'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.23' type='checkbox'  value='Autre institution gouvernementale (pr\u00e9ciser)'  id='choice_2_85_23'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_85_23' id='label_2_85_23' class='gform-field-label gform-field-label--type-inline'>Other government institution (Please specify the institution below)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_85_24'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.24' type='checkbox'  value='M\u00e9dias de masse'  id='choice_2_85_24'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_85_24' id='label_2_85_24' class='gform-field-label gform-field-label--type-inline'>Mass Media<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_85_25'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.25' type='checkbox'  value='Autre(s) (pr\u00e9ciser)'  id='choice_2_85_25'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_85_25' id='label_2_85_25' class='gform-field-label gform-field-label--type-inline'>Other(s) (Please specify)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='mm_tooltip_text' style='display:none'><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><p>FR : Par exemple, autobus, m\u00e9tro, taxi, etc. | EN : For example, autobus, metro, taxi, etc.<\/p><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><p>FR : Par exemple, journal, t\u00e9l\u00e9vision, radio, etc. | EN : For example, TV, radio, newspapers, etc.\u00a0<\/p><\/div><\/fieldset><div id=\"field_2_86\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_86'>Other government institution (Please specify the institution below)<\/label><div class='ginput_container ginput_container_text'><input name='input_86' id='input_2_86' type='text' value='' class='large' maxlength='350'     aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_151\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_151'>Other(s)<\/label><div class='ginput_container ginput_container_text'><input name='input_151' id='input_2_151' type='text' value='' class='large' maxlength='350'     aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_87\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Where did you witness this situation? <\/h3><\/div><div id=\"field_2_91\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Country*<\/h3><\/div><div id=\"field_2_88\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_88'>4T &#8211; R\u00e9gion de la violence, Pays<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_88' id='input_2_88' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Afrique du Sud' >South Africa<\/option><option value='Albanie' >Albania<\/option><option value='Alg\u00e9rie' >Algeria<\/option><option value='Allemagne' >Germany<\/option><option value='Andorre' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Antigua-et-Barbuda' >Antigua and Barbuda<\/option><option value='Arabie Saoudite' >Saudi Arabia<\/option><option value='Argentine' >Argentina<\/option><option value='Arm\u00e9nie' >Armenia<\/option><option value='Australie' >Australia<\/option><option value='Autriche' >Austria<\/option><option value='Azerba\u00efdjan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahre\u00efn' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbade' >Barbados<\/option><option value='Bi\u00e9lorussie' >Belarus<\/option><option value='Belgique' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='B\u00e9nin' >Benin<\/option><option value='Bhoutan' >Bhutan<\/option><option value='Bolivie' >Bolivia<\/option><option value='Bosnie-Herz\u00e9govine' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Brunei' >Brunei<\/option><option value='Br\u00e9sil' >Brazil<\/option><option value='Bulgarie' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cambodge' >Cambodia<\/option><option value='Cameroun' >Cameroon<\/option><option value='Canada' selected='selected'>Canada<\/option><option value='Cap-Vert' >Cabo Verde<\/option><option value='Chili' >Chile<\/option><option value='Chine' >China<\/option><option value='Chypre' >Cyprus<\/option><option value='Colombie' >Colombia<\/option><option value='Comores' >Comoros<\/option><option value='Cor\u00e9e du Nord' >North Korea<\/option><option value='Cor\u00e9e du Sud' >South Korea<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatie' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cote d&#039;Ivoire' >Cote d&#039;Ivoire<\/option><option value='Danemark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominique' >Dominica<\/option><option value='\u00c9gypte' >Egypt<\/option><option value='\u00c9mirats arabes unis' >United Arab Emirates<\/option><option value='\u00c9quateur' >Ecuador<\/option><option value='\u00c9rythr\u00e9e' >Eritrea<\/option><option value='Espagne' >Spain<\/option><option value='Estonie' >Estonia<\/option><option value='Eswatini (Swaziland)' >Eswatini (Swaziland)<\/option><option value='\u00c9tats-Unis' >United States<\/option><option value='\u00c9thiopie' >Ethiopia<\/option><option value='Fidji' >Fiji<\/option><option value='Finlande' >Finland<\/option><option value='France' >France<\/option><option value='Gabon' >Gabon<\/option><option value='Gambie' >Gambia<\/option><option value='G\u00e9orgie' >Georgia<\/option><option value='Ghana' >Ghana<\/option><option value='Grenade' >Grenada<\/option><option value='Gr\u00e8ce' >Greece<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guin\u00e9e' >Guinea<\/option><option value='Guin\u00e9e \u00e9quatoriale' >Equatorial Guinea<\/option><option value='Guin\u00e9e-Bissau' >Guinea-Bissau<\/option><option value='Guyane' >Guyana<\/option><option value='Ha\u00efti' >Haiti<\/option><option value='Honduras' >Honduras<\/option><option value='Hongrie' >Hungary<\/option><option value='\u00celes Cook' >Cook Islands<\/option><option value='\u00celes Marshall' >Marshall Islands<\/option><option value='\u00celes Salomon' >Solomon Islands<\/option><option value='Inde' >India<\/option><option value='Indon\u00e9sie' >Indonesia<\/option><option value='Irak' >Iraq<\/option><option value='Iran' >Iran<\/option><option value='Irlande' >Ireland<\/option><option value='Islande' >Iceland<\/option><option value='Isra\u00ebl' >Israel<\/option><option value='Italie' >Italy<\/option><option value='Jama\u00efque' >Jamaica<\/option><option value='Japon' >Japan<\/option><option value='Jordanie' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kirghizistan' >Kyrgyzstan<\/option><option value='Kiribati' >Kiribati<\/option><option value='Kosovo' >Kosovo<\/option><option value='Kowe\u00eft' >Kuwait<\/option><option value='Lesotho' >Lesotho<\/option><option value='Lettonie' >Latvia<\/option><option value='Liban' >Lebanon<\/option><option value='Liberia' >Liberia<\/option><option value='Libye' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lituanie' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malaisie' >Malaysia<\/option><option value='Malawi' >Malawi<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malte' >Malta<\/option><option value='Maroc' >Morocco<\/option><option value='Maurice' >Mauritius<\/option><option value='Mauritanie' >Mauritania<\/option><option value='Mexique' >Mexico<\/option><option value='Micron\u00e9sie' >Micronesia<\/option><option value='Moldavie' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolie' >Mongolia<\/option><option value='Mont\u00e9n\u00e9gro' >Montenegro<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibie' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nig\u00e9ria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norv\u00e8ge' >Norway<\/option><option value='Nouvelle-Z\u00e9lande' >New Zealand<\/option><option value='N\u00e9pal' >Nepal<\/option><option value='Oman' >Oman<\/option><option value='Ouganda' >Ouganda<\/option><option value='Ouzb\u00e9kistan' >Uzbekistan<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine' >Palestine<\/option><option value='Panama' >Panama<\/option><option value='Papouasie-Nouvelle-Guin\u00e9e' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Pays-Bas' >Netherlands<\/option><option value='Philippines' >Philippines<\/option><option value='Pologne' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='P\u00e9rou' >Peru<\/option><option value='Qatar' >Qatar<\/option><option value='R\u00e9publique Dominicaine' >Dominican Republic<\/option><option value='R\u00e9publique centrafricaine' >Central African Republic<\/option><option value='R\u00e9publique du Congo' >Congo, Republic of the<\/option><option value='R\u00e9publique d\u00e9mocratique du Congo' >Congo, Democratic Republic of<\/option><option value='R\u00e9publique d\u00e9mocratique populaire du Laos' >Laos<\/option><option value='Roumanie' >Romania<\/option><option value='Royaume-Uni' >United Kingdom<\/option><option value='Russie' >Russia<\/option><option value='Rwanda' >Rwanda<\/option><option value='Saint-Christophe-et-Nevis' >Saint Kitts and Nevis<\/option><option value='Saint-Marin' >Saint Marin<\/option><option value='Saint-Vincent-et-les Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Sainte-Lucie' >Saint Lucia<\/option><option value='Salvador' >El Salvador<\/option><option value='Samoa' >Samoa<\/option><option value='Sao Tom\u00e9 et Principe' >Sao Tome and Principe<\/option><option value='Serbie' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapour' >Singapore<\/option><option value='Slovaquie' >Slovakia<\/option><option value='Slov\u00e9nie' >Slovenia<\/option><option value='Somalie' >Somalia<\/option><option value='Soudan' >Sudan<\/option><option value='Soudan du Sud' >Sudan, South<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Suisse' >Switzerland<\/option><option value='Suriname' >Suriname<\/option><option value='Su\u00e8de' >Sweden<\/option><option value='Syrie' >Syria<\/option><option value='S\u00e9n\u00e9gal' >Senegal<\/option><option value='Ta\u00efwan' >Taiwan<\/option><option value='Tadjikistan' >Tadjikistan<\/option><option value='Tanzanie' >Tanzania<\/option><option value='Tchad' >Chad<\/option><option value='Tch\u00e9quie' >Czechia<\/option><option value='Tha\u00eflande' >Thailand<\/option><option value='Timor oriental' >East Timor (Timor-Leste)<\/option><option value='Togo' >Togo<\/option><option value='Tonga' >Tonga<\/option><option value='Trinit\u00e9 et Tobago' >Trinidad and Tobago<\/option><option value='Tunisie' >Tunisia<\/option><option value='Turkm\u00e9nistan' >Turmekistan<\/option><option value='Turquie' >Turkey<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='Ukraine' >Ukraine<\/option><option value='Uruguay' >Uruguay<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Vatican' >Vatican City<\/option><option value='Venezuela' >Venezuela<\/option><option value='Vietnam' >Vietnam<\/option><option value='Y\u00e9men' >Yemen<\/option><option value='Zambie' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><\/select><\/div><\/div><div id=\"field_2_92\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Province or territory<\/h3><\/div><div id=\"field_2_90\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_90'>4T &#8211; R\u00e9gion de la violence, Province ou territoire<\/label><div class='ginput_container ginput_container_select'><select name='input_90' id='input_2_90' class='large gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Alberta' >Alberta<\/option><option value='Colombie-Britannique' >British Columbia<\/option><option value='Manitoba' >Manitoba<\/option><option value='Nouveau-Brunswick' >New Brunswick<\/option><option value='Terre-Neuve-et-Labrador' >Newfoundland and Labrador<\/option><option value='Territoires du Nord-Ouest' >Northwest Territories<\/option><option value='Nouvelle-\u00c9cosse' >Nova Scotia<\/option><option value='Nunavut' >Nunavut<\/option><option value='Ontario' >Ontario<\/option><option value='\u00cele du Prince-\u00c9douard' >Prince Edward Island<\/option><option value='Qu\u00e9bec' >Quebec<\/option><option value='Saskatchewan' >Saskatchewan<\/option><option value='Yukon' >Yukon<\/option><\/select><\/div><\/div><fieldset id=\"field_2_144\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >4T &#8211; R\u00e9gion de la violence, Province ou territoire<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_144'><div class='gchoice gchoice_2_144_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_144.1' type='checkbox'  value='\u00e0Je pr\u00e9f\u00e8re ne pas r\u00e9pondre'  id='choice_2_144_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_144_1' id='label_2_144_1' class='gform-field-label gform-field-label--type-inline'>I prefer not to answer<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_93\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">City or town<\/h3><\/div><div id=\"field_2_89\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_89'>4T &#8211; R\u00e9gion de la violence, Ville<\/label><div class='ginput_container ginput_container_select'><select name='input_89' id='input_2_89' class='large gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Abercorn' >Abercorn<\/option><option value='Abitibi' >Abitibi<\/option><option value='Abitibi-Ouest' >Abitibi-Ouest<\/option><option value='Acton' >Acton<\/option><option value='Acton Vale' >Acton Vale<\/option><option value='Adstock' >Adstock<\/option><option value='Aguanish' >Aguanish<\/option><option value='Akulivik' >Akulivik<\/option><option value='Albanel' >Albanel<\/option><option value='Albertville' >Albertville<\/option><option value='Alleyn-et-Cawood' >Alleyn-et-Cawood<\/option><option value='Alma' >Alma<\/option><option value='Amherst' >Amherst<\/option><option value='Amos' >Amos<\/option><option value='Amqui' >Amqui<\/option><option value='Ange-Gardien' >Ange-Gardien<\/option><option value='Antoine-Labelle' >Antoine-Labelle<\/option><option value='Argenteuil' >Argenteuil<\/option><option value='Armagh' >Armagh<\/option><option value='Arthabaska' >Arthabaska<\/option><option value='Arundel' >Arundel<\/option><option value='Asbestos' >Asbestos<\/option><option value='Ascot Corner' >Ascot Corner<\/option><option value='Aston-Jonction' >Aston-Jonction<\/option><option value='Auclair' >Auclair<\/option><option value='Audet' >Audet<\/option><option value='Aumond' >Aumond<\/option><option value='Aupaluk' >Aupaluk<\/option><option value='Austin' >Austin<\/option><option value='Authier' >Authier<\/option><option value='Authier-Nord' >Authier-Nord<\/option><option value='Avignon' >Avignon<\/option><option value='Ayer&#039;s Cliff' >Ayer&#039;s Cliff<\/option><option value='Baie-Comeau' >Baie-Comeau<\/option><option value='Baie-D&#039;Urf\u00e9' >Baie-D&#039;Urf\u00e9<\/option><option value='Baie-Johan-Beetz' >Baie-Johan-Beetz<\/option><option value='Baie-Saint-Paul' >Baie-Saint-Paul<\/option><option value='Baie-Sainte-Catherine' >Baie-Sainte-Catherine<\/option><option value='Baie-Trinit\u00e9' >Baie-Trinit\u00e9<\/option><option value='Baie-des-Sables' >Baie-des-Sables<\/option><option value='Baie-du-Febvre' >Baie-du-Febvre<\/option><option value='Barkmere' >Barkmere<\/option><option value='Barnston-Ouest' >Barnston-Ouest<\/option><option value='Barraute' >Barraute<\/option><option value='Batiscan' >Batiscan<\/option><option value='Batiscan' >Batiscan<\/option><option value='B\u00e9arn' >B\u00e9arn<\/option><option value='Beauce-Sartigan' >Beauce-Sartigan<\/option><option value='Beauceville' >Beauceville<\/option><option value='Beauharnois' >Beauharnois<\/option><option value='Beauharnois-Salaberry' >Beauharnois-Salaberry<\/option><option value='Beaulac-Garthby' >Beaulac-Garthby<\/option><option value='Beaumont' >Beaumont<\/option><option value='Beaupr\u00e9' >Beaupr\u00e9<\/option><option value='B\u00e9cancour' >B\u00e9cancour<\/option><option value='Bedford' >Bedford<\/option><option value='B\u00e9gin' >B\u00e9gin<\/option><option value='Belcourt' >Belcourt<\/option><option value='Bellechasse' >Bellechasse<\/option><option value='Belleterre' >Belleterre<\/option><option value='Beloeil' >Beloeil<\/option><option value='Berry' >Berry<\/option><option value='Berthier-sur-Mer' >Berthier-sur-Mer<\/option><option value='Berthierville' >Berthierville<\/option><option value='B\u00e9thanie' >B\u00e9thanie<\/option><option value='Biencourt' >Biencourt<\/option><option value='Blainville' >Blainville<\/option><option value='Blanc-Sablon' >Blanc-Sablon<\/option><option value='Blue Sea' >Blue Sea<\/option><option value='Boileau' >Boileau<\/option><option value='Bois-Franc' >Bois-Franc<\/option><option value='Bois-des-Filion' >Bois-des-Filion<\/option><option value='Boisbriand' >Boisbriand<\/option><option value='Boischatel' >Boischatel<\/option><option value='Bolton-Est' >Bolton-Est<\/option><option value='Bolton-Ouest' >Bolton-Ouest<\/option><option value='Bonaventure' >Bonaventure<\/option><option value='Bonne-Esp\u00e9rance' >Bonne-Esp\u00e9rance<\/option><option value='Bonsecours' >Bonsecours<\/option><option value='Boucherville' >Boucherville<\/option><option value='Bouchette' >Bouchette<\/option><option value='Bowman' >Bowman<\/option><option value='Br\u00e9beuf' >Br\u00e9beuf<\/option><option value='Brigham' >Brigham<\/option><option value='Bristol' >Bristol<\/option><option value='Brome' >Brome<\/option><option value='Brome-Missisquoi' >Brome-Missisquoi<\/option><option value='Bromont' >Bromont<\/option><option value='Brossard' >Brossard<\/option><option value='Brownsburg-Chatham' >Brownsburg-Chatham<\/option><option value='Bryson' >Bryson<\/option><option value='Bury' >Bury<\/option><option value='Cacouna' >Cacouna<\/option><option value='Calixa-Lavall\u00e9e' >Calixa-Lavall\u00e9e<\/option><option value='Campbell&#039;s Bay' >Campbell&#039;s Bay<\/option><option value='Candiac' >Candiac<\/option><option value='Caniapiscau' >Caniapiscau<\/option><option value='Cantley' >Cantley<\/option><option value='Cap-Chat' >Cap-Chat<\/option><option value='Cap-Saint-Ignace' >Cap-Saint-Ignace<\/option><option value='Cap-Sant\u00e9' >Cap-Sant\u00e9<\/option><option value='Caplan' >Caplan<\/option><option value='Carignan' >Carignan<\/option><option value='Carleton-sur-Mer' >Carleton-sur-Mer<\/option><option value='Cascap\u00e9dia--Saint-Jules' >Cascap\u00e9dia&#8211;Saint-Jules<\/option><option value='Causapscal' >Causapscal<\/option><option value='Cayamant' >Cayamant<\/option><option value='Chambly' >Chambly<\/option><option value='Chambord' >Chambord<\/option><option value='Champlain' >Champlain<\/option><option value='Champneuf' >Champneuf<\/option><option value='Chandler' >Chandler<\/option><option value='Chapais' >Chapais<\/option><option value='Charette' >Charette<\/option><option value='Charlemagne' >Charlemagne<\/option><option value='Charlevoix' >Charlevoix<\/option><option value='Charlevoix-Est' >Charlevoix-Est<\/option><option value='Chartierville' >Chartierville<\/option><option value='Ch\u00e2teau-Richer' >Ch\u00e2teau-Richer<\/option><option value='Ch\u00e2teauguay' >Ch\u00e2teauguay<\/option><option value='Chazel' >Chazel<\/option><option value='Chelsea' >Chelsea<\/option><option value='Ch\u00e9n\u00e9ville' >Ch\u00e9n\u00e9ville<\/option><option value='Chertsey' >Chertsey<\/option><option value='Chesterville' >Chesterville<\/option><option value='Chibougamau' >Chibougamau<\/option><option value='Chichester' >Chichester<\/option><option value='Chisasibi' >Chisasibi<\/option><option value='Chute-Saint-Philippe' >Chute-Saint-Philippe<\/option><option value='Chute-aux-Outardes' >Chute-aux-Outardes<\/option><option value='Clarendon' >Clarendon<\/option><option value='Clermont' >Clermont<\/option><option value='Clerval' >Clerval<\/option><option value='Cleveland' >Cleveland<\/option><option value='Cloridorme' >Cloridorme<\/option><option value='Coaticook' >Coaticook<\/option><option value='Colombier' >Colombier<\/option><option value='Compton' >Compton<\/option><option value='Contrec\u0153ur' >Contrec\u0153ur<\/option><option value='Cookshire-Eaton' >Cookshire-Eaton<\/option><option value='C\u00f4te-Nord-du-Golfe-du-Saint-Laurent' >C\u00f4te-Nord-du-Golfe-du-Saint-Laurent<\/option><option value='C\u00f4te-Saint-Luc' >C\u00f4te-Saint-Luc<\/option><option value='Coteau-du-Lac' >Coteau-du-Lac<\/option><option value='Courcelles' >Courcelles<\/option><option value='Cowansville' >Cowansville<\/option><option value='Crabtree' >Crabtree<\/option><option value='D&#039;Autray' >D&#039;Autray<\/option><option value='Danville' >Danville<\/option><option value='Daveluyville' >Daveluyville<\/option><option value='D\u00e9gelis' >D\u00e9gelis<\/option><option value='D\u00e9l\u00e9age' >D\u00e9l\u00e9age<\/option><option value='Delson' >Delson<\/option><option value='Denholm' >Denholm<\/option><option value='Desbiens' >Desbiens<\/option><option value='Deschaillons-sur-Saint-Laurent' >Deschaillons-sur-Saint-Laurent<\/option><option value='Deschambault-Grondines' >Deschambault-Grondines<\/option><option value='Deux-Montagnes' >Deux-Montagnes<\/option><option value='Disraeli' >Disraeli<\/option><option value='Dixville' >Dixville<\/option><option value='Dolbeau-Mistassini' >Dolbeau-Mistassini<\/option><option value='Dollard-Des Ormeaux' >Dollard-Des Ormeaux<\/option><option value='Donnacona' >Donnacona<\/option><option value='Dorval' >Dorval<\/option><option value='Dosquet' >Dosquet<\/option><option value='Drummond' >Drummond<\/option><option value='Drummondville' >Drummondville<\/option><option value='Dudswell' >Dudswell<\/option><option value='Duhamel' >Duhamel<\/option><option value='Duhamel-Ouest' >Duhamel-Ouest<\/option><option value='Dundee' >Dundee<\/option><option value='Dunham' >Dunham<\/option><option value='Duparquet' >Duparquet<\/option><option value='Dupuy' >Dupuy<\/option><option value='Durham-Sud' >Durham-Sud<\/option><option value='East Angus' >East Angus<\/option><option value='East Broughton' >East Broughton<\/option><option value='East Farnham' >East Farnham<\/option><option value='East Hereford' >East Hereford<\/option><option value='Eastmain' >Eastmain<\/option><option value='Eastman' >Eastman<\/option><option value='Eeyou-Istchee Baie-James' >Eeyou-Istchee Baie-James<\/option><option value='Egan-Sud' >Egan-Sud<\/option><option value='Elgin' >Elgin<\/option><option value='Entrelacs' >Entrelacs<\/option><option value='Escuminac' >Escuminac<\/option><option value='Esprit-Saint' >Esprit-Saint<\/option><option value='Est\u00e9rel' >Est\u00e9rel<\/option><option value='Farnham' >Farnham<\/option><option value='Fassett' >Fassett<\/option><option value='Ferland-et-Boilleau' >Ferland-et-Boilleau<\/option><option value='Ferme-Neuve' >Ferme-Neuve<\/option><option value='Fermont' >Fermont<\/option><option value='Forestville' >Forestville<\/option><option value='Fort-Coulonge' >Fort-Coulonge<\/option><option value='Fortierville' >Fortierville<\/option><option value='Fossambault-sur-le-Lac' >Fossambault-sur-le-Lac<\/option><option value='Frampton' >Frampton<\/option><option value='Franklin' >Franklin<\/option><option value='Franquelin' >Franquelin<\/option><option value='Frelighsburg' >Frelighsburg<\/option><option value='Frontenac' >Frontenac<\/option><option value='Fug\u00e8reville' >Fug\u00e8reville<\/option><option value='Gallichan' >Gallichan<\/option><option value='Gasp\u00e9' >Gasp\u00e9<\/option><option value='Gatineau' >Gatineau<\/option><option value='Girardville' >Girardville<\/option><option value='Godbout' >Godbout<\/option><option value='Godmanchester' >Godmanchester<\/option><option value='Gore' >Gore<\/option><option value='Gracefield' >Gracefield<\/option><option value='Granby' >Granby<\/option><option value='Grand-M\u00e9tis' >Grand-M\u00e9tis<\/option><option value='Grand-Remous' >Grand-Remous<\/option><option value='Grand-Saint-Esprit' >Grand-Saint-Esprit<\/option><option value='Grande-Rivi\u00e8re' >Grande-Rivi\u00e8re<\/option><option value='Grande-Vall\u00e9e' >Grande-Vall\u00e9e<\/option><option value='Grandes-Piles' >Grandes-Piles<\/option><option value='Grenville' >Grenville<\/option><option value='Grenville-sur-la-Rouge' >Grenville-sur-la-Rouge<\/option><option value='Gros-M\u00e9catina' >Gros-M\u00e9catina<\/option><option value='Grosse-\u00cele' >Grosse-\u00cele<\/option><option value='Grosses-Roches' >Grosses-Roches<\/option><option value='Gu\u00e9rin' >Gu\u00e9rin<\/option><option value='Ham Sud' >Ham Sud<\/option><option value='Ham-Nord' >Ham-Nord<\/option><option value='Hampden' >Hampden<\/option><option value='Hampstead' >Hampstead<\/option><option value='Harrington' >Harrington<\/option><option value='Hatley' >Hatley<\/option><option value='Havelock' >Havelock<\/option><option value='Havre-Saint-Pierre' >Havre-Saint-Pierre<\/option><option value='H\u00e9bertville' >H\u00e9bertville<\/option><option value='H\u00e9bertville-Station' >H\u00e9bertville-Station<\/option><option value='Hemmingford' >Hemmingford<\/option><option value='Henryville' >Henryville<\/option><option value='H\u00e9rouxville' >H\u00e9rouxville<\/option><option value='Hinchinbrooke' >Hinchinbrooke<\/option><option value='Honfleur' >Honfleur<\/option><option value='Hope' >Hope<\/option><option value='Hope Town' >Hope Town<\/option><option value='Howick' >Howick<\/option><option value='Huberdeau' >Huberdeau<\/option><option value='Hudson' >Hudson<\/option><option value='Huntingdon' >Huntingdon<\/option><option value='Inukjuak' >Inukjuak<\/option><option value='Inverness' >Inverness<\/option><option value='Irlande' >Irlande<\/option><option value='Ivry-sur-le-Lac' >Ivry-sur-le-Lac<\/option><option value='Ivujivik' >Ivujivik<\/option><option value='Joliette' >Joliette<\/option><option value='Kamouraska' >Kamouraska<\/option><option value='Kangiqsualujjuaq' >Kangiqsualujjuaq<\/option><option value='Kangiqsujuaq' >Kangiqsujuaq<\/option><option value='Kangirsuk' >Kangirsuk<\/option><option value='Kawawachikamach' >Kawawachikamach<\/option><option value='Kazabazua' >Kazabazua<\/option><option value='Kiamika' >Kiamika<\/option><option value='Kingsbury' >Kingsbury<\/option><option value='Kingsey Falls' >Kingsey Falls<\/option><option value='Kinnear&#039;s Mills' >Kinnear&#039;s Mills<\/option><option value='Kipawa' >Kipawa<\/option><option value='Kirkland' >Kirkland<\/option><option value='Kuujjuaq' >Kuujjuaq<\/option><option value='Kuujjuarapik' >Kuujjuarapik<\/option><option value='L&#039;Ancienne-Lorette' >L&#039;Ancienne-Lorette<\/option><option value='L&#039;Ange-Gardien' >L&#039;Ange-Gardien<\/option><option value='L&#039;Anse-Saint-Jean' >L&#039;Anse-Saint-Jean<\/option><option value='L&#039;Ascension' >L&#039;Ascension<\/option><option value='L&#039;Ascension-de-Notre-Seigneur' >L&#039;Ascension-de-Notre-Seigneur<\/option><option value='L&#039;Ascension-de-Patap\u00e9dia' >L&#039;Ascension-de-Patap\u00e9dia<\/option><option value='L&#039;Assomption' >L&#039;Assomption<\/option><option value='L&#039;Avenir' >L&#039;Avenir<\/option><option value='L&#039;\u00c9piphanie' >L&#039;\u00c9piphanie<\/option><option value='L&#039;\u00c9rable' >L&#039;\u00c9rable<\/option><option value='L&#039;\u00cele-Cadieux' >L&#039;\u00cele-Cadieux<\/option><option value='L&#039;\u00cele-Dorval' >L&#039;\u00cele-Dorval<\/option><option value='L&#039;\u00cele-Perrot' >L&#039;\u00cele-Perrot<\/option><option value='L&#039;\u00cele-d&#039;Anticosti' >L&#039;\u00cele-d&#039;Anticosti<\/option><option value='L&#039;\u00cele-d&#039;Orl\u00e9ans' >L&#039;\u00cele-d&#039;Orl\u00e9ans<\/option><option value='L&#039;\u00cele-du-Grand-Calumet' >L&#039;\u00cele-du-Grand-Calumet<\/option><option value='L&#039;Isle-Verte' >L&#039;Isle-Verte<\/option><option value='L&#039;Isle-aux-Allumettes' >L&#039;Isle-aux-Allumettes<\/option><option value='L&#039;Isle-aux-Coudres' >L&#039;Isle-aux-Coudres<\/option><option value='L&#039;Islet' >L&#039;Islet<\/option><option value='La Bostonnais' >La Bostonnais<\/option><option value='La Conception' >La Conception<\/option><option value='La Corne' >La Corne<\/option><option value='La C\u00f4te-de-Beaupr\u00e9' >La C\u00f4te-de-Beaupr\u00e9<\/option><option value='La C\u00f4te-de-Gasp\u00e9' >La C\u00f4te-de-Gasp\u00e9<\/option><option value='La Dor\u00e9' >La Dor\u00e9<\/option><option value='La Durantaye' >La Durantaye<\/option><option value='La Guadeloupe' >La Guadeloupe<\/option><option value='La Haute-C\u00f4te-Nord' >La Haute-C\u00f4te-Nord<\/option><option value='La Haute-Gasp\u00e9sie' >La Haute-Gasp\u00e9sie<\/option><option value='La Haute-Yamaska' >La Haute-Yamaska<\/option><option value='La Jacques-Cartier' >La Jacques-Cartier<\/option><option value='La Macaza' >La Macaza<\/option><option value='La Malbaie' >La Malbaie<\/option><option value='La Martre' >La Martre<\/option><option value='La Matanie' >La Matanie<\/option><option value='La Matap\u00e9dia' >La Matap\u00e9dia<\/option><option value='La Minerve' >La Minerve<\/option><option value='La Mitis' >La Mitis<\/option><option value='La Morandi\u00e8re' >La Morandi\u00e8re<\/option><option value='La Motte' >La Motte<\/option><option value='La Nouvelle-Beauce' >La Nouvelle-Beauce<\/option><option value='La Patrie' >La Patrie<\/option><option value='La P\u00eache' >La P\u00eache<\/option><option value='La Pocati\u00e8re' >La Pocati\u00e8re<\/option><option value='La Prairie' >La Prairie<\/option><option value='La Pr\u00e9sentation' >La Pr\u00e9sentation<\/option><option value='La R\u00e9demption' >La R\u00e9demption<\/option><option value='La Reine' >La Reine<\/option><option value='La Rivi\u00e8re-du-Nord' >La Rivi\u00e8re-du-Nord<\/option><option value='La Sarre' >La Sarre<\/option><option value='La Trinit\u00e9-des-Monts' >La Trinit\u00e9-des-Monts<\/option><option value='La Tuque' >La Tuque<\/option><option value='La Vall\u00e9e-de-l&#039;Or' >La Vall\u00e9e-de-l&#039;Or<\/option><option value='La Vall\u00e9e-de-la-Gatineau' >La Vall\u00e9e-de-la-Gatineau<\/option><option value='La Vall\u00e9e-du-Richelieu' >La Vall\u00e9e-du-Richelieu<\/option><option value='La Visitation-de-Yamaska' >La Visitation-de-Yamaska<\/option><option value='La Visitation-de-l&#039;\u00cele-Dupas' >La Visitation-de-l&#039;\u00cele-Dupas<\/option><option value='Labelle' >Labelle<\/option><option value='Labrecque' >Labrecque<\/option><option value='Lac-Beauport' >Lac-Beauport<\/option><option value='Lac-Bouchette' >Lac-Bouchette<\/option><option value='Lac-Brome' >Lac-Brome<\/option><option value='Lac-Delage' >Lac-Delage<\/option><option value='Lac-Drolet' >Lac-Drolet<\/option><option value='Lac-\u00c9douard' >Lac-\u00c9douard<\/option><option value='Lac-Etchemin' >Lac-Etchemin<\/option><option value='Lac-Fronti\u00e8re' >Lac-Fronti\u00e8re<\/option><option value='Lac-M\u00e9gantic' >Lac-M\u00e9gantic<\/option><option value='Lac-Poulin' >Lac-Poulin<\/option><option value='Lac-Saguay' >Lac-Saguay<\/option><option value='Lac-Saint-Jean-Est' >Lac-Saint-Jean-Est<\/option><option value='Lac-Saint-Joseph' >Lac-Saint-Joseph<\/option><option value='Lac-Saint-Paul' >Lac-Saint-Paul<\/option><option value='Lac-Sainte-Marie' >Lac-Sainte-Marie<\/option><option value='Lac-Sergent' >Lac-Sergent<\/option><option value='Lac-Simon' >Lac-Simon<\/option><option value='Lac-Sup\u00e9rieur' >Lac-Sup\u00e9rieur<\/option><option value='Lac-Tremblant-Nord' >Lac-Tremblant-Nord<\/option><option value='Lac-au-Saumon' >Lac-au-Saumon<\/option><option value='Lac-aux-Sables' >Lac-aux-Sables<\/option><option value='Lac-des-Aigles' >Lac-des-Aigles<\/option><option value='Lac-des-\u00c9corces' >Lac-des-\u00c9corces<\/option><option value='Lac-des-Plages' >Lac-des-Plages<\/option><option value='Lac-des-Seize-\u00celes' >Lac-des-Seize-\u00celes<\/option><option value='Lac-du-Cerf' >Lac-du-Cerf<\/option><option value='Lachute' >Lachute<\/option><option value='Lacolle' >Lacolle<\/option><option value='Laforce' >Laforce<\/option><option value='Lamarche' >Lamarche<\/option><option value='Lambton' >Lambton<\/option><option value='Landrienne' >Landrienne<\/option><option value='Lanoraie' >Lanoraie<\/option><option value='Lantier' >Lantier<\/option><option value='Larouche' >Larouche<\/option><option value='Latulipe-et-Gaboury' >Latulipe-et-Gaboury<\/option><option value='Launay' >Launay<\/option><option value='Laurier-Station' >Laurier-Station<\/option><option value='Laurierville' >Laurierville<\/option><option value='Laval' >Laval<\/option><option value='Lavaltrie' >Lavaltrie<\/option><option value='Laverloch\u00e8re Angliers' >Laverloch\u00e8re Angliers<\/option><option value='Lawrenceville' >Lawrenceville<\/option><option value='Le Domaine-du-Roy' >Le Domaine-du-Roy<\/option><option value='Le Fjord-du-Saguenay' >Le Fjord-du-Saguenay<\/option><option value='Le Golfe-du-Saint-Laurent' >Le Golfe-du-Saint-Laurent<\/option><option value='Le Granit' >Le Granit<\/option><option value='Le Haut-Richelieu' >Le Haut-Richelieu<\/option><option value='Le Haut-Saint-Fran\u00e7ois' >Le Haut-Saint-Fran\u00e7ois<\/option><option value='Le Haut-Saint-Laurent' >Le Haut-Saint-Laurent<\/option><option value='Le Rocher-Perc\u00e9' >Le Rocher-Perc\u00e9<\/option><option value='Le Val-Saint-Fran\u00e7ois' >Le Val-Saint-Fran\u00e7ois<\/option><option value='Lebel-sur-Qu\u00e9villon' >Lebel-sur-Qu\u00e9villon<\/option><option value='Leclercville' >Leclercville<\/option><option value='Lefebvre' >Lefebvre<\/option><option value='Lejeune' >Lejeune<\/option><option value='Lemieux' >Lemieux<\/option><option value='L\u00e9ry' >L\u00e9ry<\/option><option value='Les Appalaches' >Les Appalaches<\/option><option value='Les Basques' >Les Basques<\/option><option value='Les Bergeronnes' >Les Bergeronnes<\/option><option value='Les C\u00e8dres' >Les C\u00e8dres<\/option><option value='Les Chenaux' >Les Chenaux<\/option><option value='Les Collines-de-l&#039;Outaouais' >Les Collines-de-l&#039;Outaouais<\/option><option value='Les Coteaux' >Les Coteaux<\/option><option value='Les \u00c9boulements' >Les \u00c9boulements<\/option><option value='Les Escoumins' >Les Escoumins<\/option><option value='Les Etchemins' >Les Etchemins<\/option><option value='Les Hauteurs' >Les Hauteurs<\/option><option value='Les \u00celes-de-la-Madeleine' >Les \u00celes-de-la-Madeleine<\/option><option value='Les Jardins-de-Napierville' >Les Jardins-de-Napierville<\/option><option value='Les Laurentides' >Les Laurentides<\/option><option value='Les Maskoutains' >Les Maskoutains<\/option><option value='Les M\u00e9chins' >Les M\u00e9chins<\/option><option value='Les Moulins' >Les Moulins<\/option><option value='Les Pays-d&#039;en-Haut' >Les Pays-d&#039;en-Haut<\/option><option value='Les Sources' >Les Sources<\/option><option value='L\u00e9vis' >L\u00e9vis<\/option><option value='Lingwick' >Lingwick<\/option><option value='Litchfield' >Litchfield<\/option><option value='Lochaber' >Lochaber<\/option><option value='Lochaber-Partie-Ouest' >Lochaber-Partie-Ouest<\/option><option value='Longue-Pointe-de-Mingan' >Longue-Pointe-de-Mingan<\/option><option value='Longue-Rive' >Longue-Rive<\/option><option value='Longueuil' >Longueuil<\/option><option value='Lorraine' >Lorraine<\/option><option value='Lorrainville' >Lorrainville<\/option><option value='Lotbini\u00e8re' >Lotbini\u00e8re<\/option><option value='Louiseville' >Louiseville<\/option><option value='Low' >Low<\/option><option value='Lyster' >Lyster<\/option><option value='Macamic' >Macamic<\/option><option value='Maddington Falls' >Maddington Falls<\/option><option value='Magog' >Magog<\/option><option value='Malartic' >Malartic<\/option><option value='Mandeville' >Mandeville<\/option><option value='Manicouagan' >Manicouagan<\/option><option value='Maniwaki' >Maniwaki<\/option><option value='Manseau' >Manseau<\/option><option value='Mansfield-et-Pontefract' >Mansfield-et-Pontefract<\/option><option value='Marguerite-D&#039;Youville' >Marguerite-D&#039;Youville<\/option><option value='Maria' >Maria<\/option><option value='Maria-Chapdelaine' >Maria-Chapdelaine<\/option><option value='Maricourt' >Maricourt<\/option><option value='Marieville' >Marieville<\/option><option value='Marsoui' >Marsoui<\/option><option value='Marston' >Marston<\/option><option value='Martinville' >Martinville<\/option><option value='Mascouche' >Mascouche<\/option><option value='Maskinong\u00e9' >Maskinong\u00e9<\/option><option value='Massueville' >Massueville<\/option><option value='Matagami' >Matagami<\/option><option value='Matane' >Matane<\/option><option value='Matap\u00e9dia' >Matap\u00e9dia<\/option><option value='Matawinie' >Matawinie<\/option><option value='Mayo' >Mayo<\/option><option value='McMasterville' >McMasterville<\/option><option value='M\u00e9kinac' >M\u00e9kinac<\/option><option value='Melbourne' >Melbourne<\/option><option value='Memphr\u00e9magog' >Memphr\u00e9magog<\/option><option value='Mercier' >Mercier<\/option><option value='Messines' >Messines<\/option><option value='M\u00e9tabetchouan--Lac-\u00e0-la-Croix' >M\u00e9tabetchouan&#8211;Lac-\u00e0-la-Croix<\/option><option value='M\u00e9tis-sur-Mer' >M\u00e9tis-sur-Mer<\/option><option value='Milan' >Milan<\/option><option value='Mille-Isles' >Mille-Isles<\/option><option value='Minganie' >Minganie<\/option><option value='Mirabel' >Mirabel<\/option><option value='Mistissini' >Mistissini<\/option><option value='Moffet' >Moffet<\/option><option value='Mont-Carmel' >Mont-Carmel<\/option><option value='Mont-Joli' >Mont-Joli<\/option><option value='Mont-Laurier' >Mont-Laurier<\/option><option value='Mont-Royal' >Mont-Royal<\/option><option value='Mont-Saint-Gr\u00e9goire' >Mont-Saint-Gr\u00e9goire<\/option><option value='Mont-Saint-Hilaire' >Mont-Saint-Hilaire<\/option><option value='Mont-Saint-Michel' >Mont-Saint-Michel<\/option><option value='Mont-Saint-Pierre' >Mont-Saint-Pierre<\/option><option value='Mont-Tremblant' >Mont-Tremblant<\/option><option value='Montcalm' >Montcalm<\/option><option value='Montcerf-Lytton' >Montcerf-Lytton<\/option><option value='Montebello' >Montebello<\/option><option value='Montmagny' >Montmagny<\/option><option value='Montpellier' >Montpellier<\/option><option value='Montr\u00e9al' >Montr\u00e9al<\/option><option value='Montr\u00e9al-Est' >Montr\u00e9al-Est<\/option><option value='Montr\u00e9al-Ouest' >Montr\u00e9al-Ouest<\/option><option value='Morin-Heights' >Morin-Heights<\/option><option value='Mulgrave-et-Derry' >Mulgrave-et-Derry<\/option><option value='Murdochville' >Murdochville<\/option><option value='Namur' >Namur<\/option><option value='Nantes' >Nantes<\/option><option value='Napierville' >Napierville<\/option><option value='Natashquan' >Natashquan<\/option><option value='N\u00e9d\u00e9lec' >N\u00e9d\u00e9lec<\/option><option value='Nemaska' >Nemaska<\/option><option value='Neuville' >Neuville<\/option><option value='New Carlisle' >New Carlisle<\/option><option value='New Richmond' >New Richmond<\/option><option value='Newport' >Newport<\/option><option value='Nicolet' >Nicolet<\/option><option value='Nicolet-Yamaska' >Nicolet-Yamaska<\/option><option value='Nominingue' >Nominingue<\/option><option value='Normandin' >Normandin<\/option><option value='Norm\u00e9tal' >Norm\u00e9tal<\/option><option value='North Hatley' >North Hatley<\/option><option value='Notre-Dame-Auxiliatrice-de-Buckland' >Notre-Dame-Auxiliatrice-de-Buckland<\/option><option value='Notre-Dame-de-Bonsecours' >Notre-Dame-de-Bonsecours<\/option><option value='Notre-Dame-de-Ham' >Notre-Dame-de-Ham<\/option><option value='Notre-Dame-de-Lorette' >Notre-Dame-de-Lorette<\/option><option value='Notre-Dame-de-Lourdes' >Notre-Dame-de-Lourdes<\/option><option value='Notre-Dame-de-Montauban' >Notre-Dame-de-Montauban<\/option><option value='Notre-Dame-de-Pontmain' >Notre-Dame-de-Pontmain<\/option><option value='Notre-Dame-de-Stanbridge' >Notre-Dame-de-Stanbridge<\/option><option value='Notre-Dame-de-l&#039;\u00cele-Perrot' >Notre-Dame-de-l&#039;\u00cele-Perrot<\/option><option value='Notre-Dame-de-la-Merci' >Notre-Dame-de-la-Merci<\/option><option value='Notre-Dame-de-la-Paix' >Notre-Dame-de-la-Paix<\/option><option value='Notre-Dame-de-la-Salette' >Notre-Dame-de-la-Salette<\/option><option value='Notre-Dame-des-Anges' >Notre-Dame-des-Anges<\/option><option value='Notre-Dame-des-Bois' >Notre-Dame-des-Bois<\/option><option value='Notre-Dame-des-Monts' >Notre-Dame-des-Monts<\/option><option value='Notre-Dame-des-Neiges' >Notre-Dame-des-Neiges<\/option><option value='Notre-Dame-des-Pins' >Notre-Dame-des-Pins<\/option><option value='Notre-Dame-des-Prairies' >Notre-Dame-des-Prairies<\/option><option value='Notre-Dame-des-Sept-Douleurs' >Notre-Dame-des-Sept-Douleurs<\/option><option value='Notre-Dame-du-Bon-Conseil' >Notre-Dame-du-Bon-Conseil<\/option><option value='Notre-Dame-du-Bon-Conseil' >Notre-Dame-du-Bon-Conseil<\/option><option value='Notre-Dame-du-Laus' >Notre-Dame-du-Laus<\/option><option value='Notre-Dame-du-Mont-Carmel' >Notre-Dame-du-Mont-Carmel<\/option><option value='Notre-Dame-du-Nord' >Notre-Dame-du-Nord<\/option><option value='Notre-Dame-du-Portage' >Notre-Dame-du-Portage<\/option><option value='Notre-Dame-du-Rosaire' >Notre-Dame-du-Rosaire<\/option><option value='Notre-Dame-du-Sacr\u00e9-C\u0153ur-d&#039;Issoudun' >Notre-Dame-du-Sacr\u00e9-C\u0153ur-d&#039;Issoudun<\/option><option value='Nouvelle' >Nouvelle<\/option><option value='Noyan' >Noyan<\/option><option value='Ogden' >Ogden<\/option><option value='Oka' >Oka<\/option><option value='Orford' >Orford<\/option><option value='Ormstown' >Ormstown<\/option><option value='Otter Lake' >Otter Lake<\/option><option value='Otterburn Park' >Otterburn Park<\/option><option value='Packington' >Packington<\/option><option value='Padoue' >Padoue<\/option><option value='Palmarolle' >Palmarolle<\/option><option value='Papineau' >Papineau<\/option><option value='Papineauville' >Papineauville<\/option><option value='Parisville' >Parisville<\/option><option value='Pasp\u00e9biac' >Pasp\u00e9biac<\/option><option value='Perc\u00e9' >Perc\u00e9<\/option><option value='P\u00e9ribonka' >P\u00e9ribonka<\/option><option value='Petit-Saguenay' >Petit-Saguenay<\/option><option value='Petite-Rivi\u00e8re-Saint-Fran\u00e7ois' >Petite-Rivi\u00e8re-Saint-Fran\u00e7ois<\/option><option value='Petite-Vall\u00e9e' >Petite-Vall\u00e9e<\/option><option value='Piedmont' >Piedmont<\/option><option value='Pierre-De Saurel' >Pierre-De Saurel<\/option><option value='Pierreville' >Pierreville<\/option><option value='Pike-River' >Pike-River<\/option><option value='Pincourt' >Pincourt<\/option><option value='Piopolis' >Piopolis<\/option><option value='Plaisance' >Plaisance<\/option><option value='Plessisville' >Plessisville<\/option><option value='Poh\u00e9n\u00e9gamook' >Poh\u00e9n\u00e9gamook<\/option><option value='Pointe-Calumet' >Pointe-Calumet<\/option><option value='Pointe-Claire' >Pointe-Claire<\/option><option value='Pointe-Fortune' >Pointe-Fortune<\/option><option value='Pointe-Lebel' >Pointe-Lebel<\/option><option value='Pointe-\u00e0-la-Croix' >Pointe-\u00e0-la-Croix<\/option><option value='Pointe-aux-Outardes' >Pointe-aux-Outardes<\/option><option value='Pointe-des-Cascades' >Pointe-des-Cascades<\/option><option value='Pont-Rouge' >Pont-Rouge<\/option><option value='Pontiac' >Pontiac<\/option><option value='Port-Cartier' >Port-Cartier<\/option><option value='Port-Daniel--Gascons' >Port-Daniel&#8211;Gascons<\/option><option value='Portage-du-Fort' >Portage-du-Fort<\/option><option value='Portneuf-sur-Mer' >Portneuf-sur-Mer<\/option><option value='Potton' >Potton<\/option><option value='Poularies' >Poularies<\/option><option value='Preissac' >Preissac<\/option><option value='Pr\u00e9vost' >Pr\u00e9vost<\/option><option value='Price' >Price<\/option><option value='Princeville' >Princeville<\/option><option value='Puvirnituq' >Puvirnituq<\/option><option value='Quaqtaq' >Quaqtaq<\/option><option value='Quebec City' >Quebec City<\/option><option value='Racine' >Racine<\/option><option value='Ragueneau' >Ragueneau<\/option><option value='Rapide-Danseur' >Rapide-Danseur<\/option><option value='Rapides-des-Joachims' >Rapides-des-Joachims<\/option><option value='Rawdon' >Rawdon<\/option><option value='R\u00e9migny' >R\u00e9migny<\/option><option value='Repentigny' >Repentigny<\/option><option value='Richelieu' >Richelieu<\/option><option value='Richmond' >Richmond<\/option><option value='Rigaud' >Rigaud<\/option><option value='Rimouski' >Rimouski<\/option><option value='Rimouski-Neigette' >Rimouski-Neigette<\/option><option value='Ripon' >Ripon<\/option><option value='Ristigouche-Partie-Sud-Est' >Ristigouche-Partie-Sud-Est<\/option><option value='Rivi\u00e8re-Beaudette' >Rivi\u00e8re-Beaudette<\/option><option value='Rivi\u00e8re-Bleue' >Rivi\u00e8re-Bleue<\/option><option value='Rivi\u00e8re-\u00c9ternit\u00e9' >Rivi\u00e8re-\u00c9ternit\u00e9<\/option><option value='Rivi\u00e8re-H\u00e9va' >Rivi\u00e8re-H\u00e9va<\/option><option value='Rivi\u00e8re-Ouelle' >Rivi\u00e8re-Ouelle<\/option><option value='Rivi\u00e8re-Rouge' >Rivi\u00e8re-Rouge<\/option><option value='Rivi\u00e8re-Saint-Jean' >Rivi\u00e8re-Saint-Jean<\/option><option value='Rivi\u00e8re-\u00e0-Claude' >Rivi\u00e8re-\u00e0-Claude<\/option><option value='Rivi\u00e8re-\u00e0-Pierre' >Rivi\u00e8re-\u00e0-Pierre<\/option><option value='Rivi\u00e8re-au-Tonnerre' >Rivi\u00e8re-au-Tonnerre<\/option><option value='Rivi\u00e8re-du-Loup' >Rivi\u00e8re-du-Loup<\/option><option value='Robert-Cliche' >Robert-Cliche<\/option><option value='Roberval' >Roberval<\/option><option value='Rochebaucourt' >Rochebaucourt<\/option><option value='Roquemaure' >Roquemaure<\/option><option value='Rosem\u00e8re' >Rosem\u00e8re<\/option><option value='Rougemont' >Rougemont<\/option><option value='Roussillon' >Roussillon<\/option><option value='Rouville' >Rouville<\/option><option value='Rouyn-Noranda' >Rouyn-Noranda<\/option><option value='Roxton' >Roxton<\/option><option value='Roxton Falls' >Roxton Falls<\/option><option value='Roxton Pond' >Roxton Pond<\/option><option value='Sacr\u00e9-C\u0153ur' >Sacr\u00e9-C\u0153ur<\/option><option value='Sacr\u00e9-C\u0153ur-de-J\u00e9sus' >Sacr\u00e9-C\u0153ur-de-J\u00e9sus<\/option><option value='Saguenay' >Saguenay<\/option><option value='Saint-Adalbert' >Saint-Adalbert<\/option><option value='Saint-Adelme' >Saint-Adelme<\/option><option value='Saint-Adelphe' >Saint-Adelphe<\/option><option value='Saint-Adolphe-d&#039;Howard' >Saint-Adolphe-d&#039;Howard<\/option><option value='Saint-Adrien' >Saint-Adrien<\/option><option value='Saint-Adrien-d&#039;Irlande' >Saint-Adrien-d&#039;Irlande<\/option><option value='Saint-Agapit' >Saint-Agapit<\/option><option value='Saint-Aim\u00e9' >Saint-Aim\u00e9<\/option><option value='Saint-Aim\u00e9-des-Lacs' >Saint-Aim\u00e9-des-Lacs<\/option><option value='Saint-Aim\u00e9-du-Lac-des-\u00celes' >Saint-Aim\u00e9-du-Lac-des-\u00celes<\/option><option value='Saint-Alban' >Saint-Alban<\/option><option value='Saint-Albert' >Saint-Albert<\/option><option value='Saint-Alexandre' >Saint-Alexandre<\/option><option value='Saint-Alexandre-de-Kamouraska' >Saint-Alexandre-de-Kamouraska<\/option><option value='Saint-Alexandre-des-Lacs' >Saint-Alexandre-des-Lacs<\/option><option value='Saint-Alexis' >Saint-Alexis<\/option><option value='Saint-Alexis-de-Matap\u00e9dia' >Saint-Alexis-de-Matap\u00e9dia<\/option><option value='Saint-Alexis-des-Monts' >Saint-Alexis-des-Monts<\/option><option value='Saint-Alfred' >Saint-Alfred<\/option><option value='Saint-Alphonse' >Saint-Alphonse<\/option><option value='Saint-Alphonse-Rodriguez' >Saint-Alphonse-Rodriguez<\/option><option value='Saint-Alphonse-de-Granby' >Saint-Alphonse-de-Granby<\/option><option value='Saint-Amable' >Saint-Amable<\/option><option value='Saint-Ambroise' >Saint-Ambroise<\/option><option value='Saint-Ambroise-de-Kildare' >Saint-Ambroise-de-Kildare<\/option><option value='Saint-Anaclet-de-Lessard' >Saint-Anaclet-de-Lessard<\/option><option value='Saint-Andr\u00e9' >Saint-Andr\u00e9<\/option><option value='Saint-Andr\u00e9-Avellin' >Saint-Andr\u00e9-Avellin<\/option><option value='Saint-Andr\u00e9-d&#039;Argenteuil' >Saint-Andr\u00e9-d&#039;Argenteuil<\/option><option value='Saint-Andr\u00e9-de-Restigouche' >Saint-Andr\u00e9-de-Restigouche<\/option><option value='Saint-Andr\u00e9-du-Lac-Saint-Jean' >Saint-Andr\u00e9-du-Lac-Saint-Jean<\/option><option value='Saint-Anicet' >Saint-Anicet<\/option><option value='Saint-Anselme' >Saint-Anselme<\/option><option value='Saint-Antoine-de-Tilly' >Saint-Antoine-de-Tilly<\/option><option value='Saint-Antoine-de-l&#039;Isle-aux-Grues' >Saint-Antoine-de-l&#039;Isle-aux-Grues<\/option><option value='Saint-Antoine-sur-Richelieu' >Saint-Antoine-sur-Richelieu<\/option><option value='Saint-Antonin' >Saint-Antonin<\/option><option value='Saint-Apollinaire' >Saint-Apollinaire<\/option><option value='Saint-Armand' >Saint-Armand<\/option><option value='Saint-Ars\u00e8ne' >Saint-Ars\u00e8ne<\/option><option value='Saint-Athanase' >Saint-Athanase<\/option><option value='Saint-Aubert' >Saint-Aubert<\/option><option value='Saint-Augustin' >Saint-Augustin<\/option><option value='Saint-Augustin-de-Desmaures' >Saint-Augustin-de-Desmaures<\/option><option value='Saint-Augustin-de-Woburn' >Saint-Augustin-de-Woburn<\/option><option value='Saint-Barnab\u00e9' >Saint-Barnab\u00e9<\/option><option value='Saint-Barnab\u00e9-Sud' >Saint-Barnab\u00e9-Sud<\/option><option value='Saint-Barth\u00e9lemy' >Saint-Barth\u00e9lemy<\/option><option value='Saint-Basile' >Saint-Basile<\/option><option value='Saint-Basile-le-Grand' >Saint-Basile-le-Grand<\/option><option value='Saint-Benjamin' >Saint-Benjamin<\/option><option value='Saint-Beno\u00eet-Labre' >Saint-Beno\u00eet-Labre<\/option><option value='Saint-Beno\u00eet-du-Lac' >Saint-Beno\u00eet-du-Lac<\/option><option value='Saint-Bernard' >Saint-Bernard<\/option><option value='Saint-Bernard-de-Lacolle' >Saint-Bernard-de-Lacolle<\/option><option value='Saint-Bernard-de-Michaudville' >Saint-Bernard-de-Michaudville<\/option><option value='Saint-Blaise-sur-Richelieu' >Saint-Blaise-sur-Richelieu<\/option><option value='Saint-Bonaventure' >Saint-Bonaventure<\/option><option value='Saint-Boniface' >Saint-Boniface<\/option><option value='Saint-Bruno' >Saint-Bruno<\/option><option value='Saint-Bruno-de-Guigues' >Saint-Bruno-de-Guigues<\/option><option value='Saint-Bruno-de-Kamouraska' >Saint-Bruno-de-Kamouraska<\/option><option value='Saint-Bruno-de-Montarville' >Saint-Bruno-de-Montarville<\/option><option value='Saint-Calixte' >Saint-Calixte<\/option><option value='Saint-Camille' >Saint-Camille<\/option><option value='Saint-Camille-de-Lellis' >Saint-Camille-de-Lellis<\/option><option value='Saint-Casimir' >Saint-Casimir<\/option><option value='Saint-C\u00e9lestin' >Saint-C\u00e9lestin<\/option><option value='Saint-C\u00e9saire' >Saint-C\u00e9saire<\/option><option value='Saint-Charles-Borrom\u00e9e' >Saint-Charles-Borrom\u00e9e<\/option><option value='Saint-Charles-Garnier' >Saint-Charles-Garnier<\/option><option value='Saint-Charles-de-Bellechasse' >Saint-Charles-de-Bellechasse<\/option><option value='Saint-Charles-de-Bourget' >Saint-Charles-de-Bourget<\/option><option value='Saint-Charles-sur-Richelieu' >Saint-Charles-sur-Richelieu<\/option><option value='Saint-Christophe-d&#039;Arthabaska' >Saint-Christophe-d&#039;Arthabaska<\/option><option value='Saint-Chrysostome' >Saint-Chrysostome<\/option><option value='Saint-Claude' >Saint-Claude<\/option><option value='Saint-Cl\u00e9ment' >Saint-Cl\u00e9ment<\/option><option value='Saint-Cl\u00e9ophas' >Saint-Cl\u00e9ophas<\/option><option value='Saint-Cl\u00e9ophas-de-Brandon' >Saint-Cl\u00e9ophas-de-Brandon<\/option><option value='Saint-Clet' >Saint-Clet<\/option><option value='Saint-Colomban' >Saint-Colomban<\/option><option value='Saint-C\u00f4me' >Saint-C\u00f4me<\/option><option value='Saint-C\u00f4me-Lini\u00e8re' >Saint-C\u00f4me-Lini\u00e8re<\/option><option value='Saint-Constant' >Saint-Constant<\/option><option value='Saint-Cuthbert' >Saint-Cuthbert<\/option><option value='Saint-Cyprien' >Saint-Cyprien<\/option><option value='Saint-Cyprien-de-Napierville' >Saint-Cyprien-de-Napierville<\/option><option value='Saint-Cyrille-de-Lessard' >Saint-Cyrille-de-Lessard<\/option><option value='Saint-Cyrille-de-Wendover' >Saint-Cyrille-de-Wendover<\/option><option value='Saint-Damase' >Saint-Damase<\/option><option value='Saint-Damase-de-L&#039;Islet' >Saint-Damase-de-L&#039;Islet<\/option><option value='Saint-Damien' >Saint-Damien<\/option><option value='Saint-Damien-de-Buckland' >Saint-Damien-de-Buckland<\/option><option value='Saint-David' >Saint-David<\/option><option value='Saint-David-de-Falardeau' >Saint-David-de-Falardeau<\/option><option value='Saint-Denis-de-Brompton' >Saint-Denis-de-Brompton<\/option><option value='Saint-Denis-de-la-Bouteillerie' >Saint-Denis-de-la-Bouteillerie<\/option><option value='Saint-Denis-sur-Richelieu' >Saint-Denis-sur-Richelieu<\/option><option value='Saint-Denis-sur-Richelieu' >Saint-Denis-sur-Richelieu<\/option><option value='Saint-Dominique' >Saint-Dominique<\/option><option value='Saint-Dominique-du-Rosaire' >Saint-Dominique-du-Rosaire<\/option><option value='Saint-Donat' >Saint-Donat<\/option><option value='Saint-Edmond-de-Grantham' >Saint-Edmond-de-Grantham<\/option><option value='Saint-Edmond-les-Plaines' >Saint-Edmond-les-Plaines<\/option><option value='Saint-\u00c9douard' >Saint-\u00c9douard<\/option><option value='Saint-\u00c9douard-de-Fabre' >Saint-\u00c9douard-de-Fabre<\/option><option value='Saint-\u00c9douard-de-Lotbini\u00e8re' >Saint-\u00c9douard-de-Lotbini\u00e8re<\/option><option value='Saint-\u00c9douard-de-Maskinong\u00e9' >Saint-\u00c9douard-de-Maskinong\u00e9<\/option><option value='Saint-\u00c9lie-de-Caxton' >Saint-\u00c9lie-de-Caxton<\/option><option value='Saint-\u00c9loi' >Saint-\u00c9loi<\/option><option value='Saint-Elph\u00e8ge' >Saint-Elph\u00e8ge<\/option><option value='Saint-Elz\u00e9ar' >Saint-Elz\u00e9ar<\/option><option value='Saint-Elz\u00e9ar-de-T\u00e9miscouata' >Saint-Elz\u00e9ar-de-T\u00e9miscouata<\/option><option value='Saint-\u00c9mile-de-Suffolk' >Saint-\u00c9mile-de-Suffolk<\/option><option value='Saint-\u00c9phrem-de-Beauce' >Saint-\u00c9phrem-de-Beauce<\/option><option value='Saint-\u00c9piphane' >Saint-\u00c9piphane<\/option><option value='Saint-Esprit' >Saint-Esprit<\/option><option value='Saint-\u00c9tienne-de-Beauharnois' >Saint-\u00c9tienne-de-Beauharnois<\/option><option value='Saint-\u00c9tienne-de-Bolton' >Saint-\u00c9tienne-de-Bolton<\/option><option value='Saint-\u00c9tienne-des-Gr\u00e8s' >Saint-\u00c9tienne-des-Gr\u00e8s<\/option><option value='Saint-Eug\u00e8ne' >Saint-Eug\u00e8ne<\/option><option value='Saint-Eug\u00e8ne-d&#039;Argentenay' >Saint-Eug\u00e8ne-d&#039;Argentenay<\/option><option value='Saint-Eug\u00e8ne-de-Guigues' >Saint-Eug\u00e8ne-de-Guigues<\/option><option value='Saint-Eug\u00e8ne-de-Ladri\u00e8re' >Saint-Eug\u00e8ne-de-Ladri\u00e8re<\/option><option value='Saint-Eus\u00e8be' >Saint-Eus\u00e8be<\/option><option value='Saint-Eustache' >Saint-Eustache<\/option><option value='Saint-\u00c9variste-de-Forsyth' >Saint-\u00c9variste-de-Forsyth<\/option><option value='Saint-Fabien' >Saint-Fabien<\/option><option value='Saint-Fabien-de-Panet' >Saint-Fabien-de-Panet<\/option><option value='Saint-Faustin--Lac-Carr\u00e9' >Saint-Faustin&#8211;Lac-Carr\u00e9<\/option><option value='Saint-F\u00e9licien' >Saint-F\u00e9licien<\/option><option value='Saint-F\u00e9lix-d&#039;Otis' >Saint-F\u00e9lix-d&#039;Otis<\/option><option value='Saint-F\u00e9lix-de-Dalquier' >Saint-F\u00e9lix-de-Dalquier<\/option><option value='Saint-F\u00e9lix-de-Kingsey' >Saint-F\u00e9lix-de-Kingsey<\/option><option value='Saint-F\u00e9lix-de-Valois' >Saint-F\u00e9lix-de-Valois<\/option><option value='Saint-Ferdinand' >Saint-Ferdinand<\/option><option value='Saint-Ferr\u00e9ol-les-Neiges' >Saint-Ferr\u00e9ol-les-Neiges<\/option><option value='Saint-Flavien' >Saint-Flavien<\/option><option value='Saint-Fortunat' >Saint-Fortunat<\/option><option value='Saint-Fran\u00e7ois-Xavier-de-Brompton' >Saint-Fran\u00e7ois-Xavier-de-Brompton<\/option><option value='Saint-Fran\u00e7ois-Xavier-de-Viger' >Saint-Fran\u00e7ois-Xavier-de-Viger<\/option><option value='Saint-Fran\u00e7ois-d&#039;Assise' >Saint-Fran\u00e7ois-d&#039;Assise<\/option><option value='Saint-Fran\u00e7ois-de-Sales' >Saint-Fran\u00e7ois-de-Sales<\/option><option value='Saint-Fran\u00e7ois-de-l&#039;\u00cele-d&#039;Orl\u00e9ans' >Saint-Fran\u00e7ois-de-l&#039;\u00cele-d&#039;Orl\u00e9ans<\/option><option value='Saint-Fran\u00e7ois-de-la-Rivi\u00e8re-du-Sud' >Saint-Fran\u00e7ois-de-la-Rivi\u00e8re-du-Sud<\/option><option value='Saint-Fran\u00e7ois-du-Lac' >Saint-Fran\u00e7ois-du-Lac<\/option><option value='Saint-Fr\u00e9d\u00e9ric' >Saint-Fr\u00e9d\u00e9ric<\/option><option value='Saint-Fulgence' >Saint-Fulgence<\/option><option value='Saint-Gabriel' >Saint-Gabriel<\/option><option value='Saint-Gabriel-Lalemant' >Saint-Gabriel-Lalemant<\/option><option value='Saint-Gabriel-de-Brandon' >Saint-Gabriel-de-Brandon<\/option><option value='Saint-Gabriel-de-Rimouski' >Saint-Gabriel-de-Rimouski<\/option><option value='Saint-Gabriel-de-Valcartier' >Saint-Gabriel-de-Valcartier<\/option><option value='Saint-G\u00e9d\u00e9on' >Saint-G\u00e9d\u00e9on<\/option><option value='Saint-G\u00e9d\u00e9on-de-Beauce' >Saint-G\u00e9d\u00e9on-de-Beauce<\/option><option value='Saint-Georges' >Saint-Georges<\/option><option value='Saint-Georges-de-Clarenceville' >Saint-Georges-de-Clarenceville<\/option><option value='Saint-Georges-de-Windsor' >Saint-Georges-de-Windsor<\/option><option value='Saint-G\u00e9rard-Majella' >Saint-G\u00e9rard-Majella<\/option><option value='Saint-Germain' >Saint-Germain<\/option><option value='Saint-Germain-de-Grantham' >Saint-Germain-de-Grantham<\/option><option value='Saint-Gervais' >Saint-Gervais<\/option><option value='Saint-Gilbert' >Saint-Gilbert<\/option><option value='Saint-Gilles' >Saint-Gilles<\/option><option value='Saint-Godefroi' >Saint-Godefroi<\/option><option value='Saint-Guillaume' >Saint-Guillaume<\/option><option value='Saint-Guy' >Saint-Guy<\/option><option value='Saint-Henri' >Saint-Henri<\/option><option value='Saint-Henri-de-Taillon' >Saint-Henri-de-Taillon<\/option><option value='Saint-Herm\u00e9n\u00e9gilde' >Saint-Herm\u00e9n\u00e9gilde<\/option><option value='Saint-Hilaire-de-Dorset' >Saint-Hilaire-de-Dorset<\/option><option value='Saint-Hilarion' >Saint-Hilarion<\/option><option value='Saint-Hippolyte' >Saint-Hippolyte<\/option><option value='Saint-Honor\u00e9' >Saint-Honor\u00e9<\/option><option value='Saint-Honor\u00e9-de-Shenley' >Saint-Honor\u00e9-de-Shenley<\/option><option value='Saint-Honor\u00e9-de-T\u00e9miscouata' >Saint-Honor\u00e9-de-T\u00e9miscouata<\/option><option value='Saint-Hubert-de-Rivi\u00e8re-du-Loup' >Saint-Hubert-de-Rivi\u00e8re-du-Loup<\/option><option value='Saint-Hugues' >Saint-Hugues<\/option><option value='Saint-Hyacinthe' >Saint-Hyacinthe<\/option><option value='Saint-Ignace-de-Loyola' >Saint-Ignace-de-Loyola<\/option><option value='Saint-Ignace-de-Stanbridge' >Saint-Ignace-de-Stanbridge<\/option><option value='Saint-Ir\u00e9n\u00e9e' >Saint-Ir\u00e9n\u00e9e<\/option><option value='Saint-Isidore' >Saint-Isidore<\/option><option value='Saint-Isidore-de-Clifton' >Saint-Isidore-de-Clifton<\/option><option value='Saint-Jacques' >Saint-Jacques<\/option><option value='Saint-Jacques-de-Leeds' >Saint-Jacques-de-Leeds<\/option><option value='Saint-Jacques-le-Majeur-de-Wolfestown' >Saint-Jacques-le-Majeur-de-Wolfestown<\/option><option value='Saint-Jacques-le-Mineur' >Saint-Jacques-le-Mineur<\/option><option value='Saint-Janvier-de-Joly' >Saint-Janvier-de-Joly<\/option><option value='Saint-Jean-Baptiste' >Saint-Jean-Baptiste<\/option><option value='Saint-Jean-Port-Joli' >Saint-Jean-Port-Joli<\/option><option value='Saint-Jean-de-Br\u00e9beuf' >Saint-Jean-de-Br\u00e9beuf<\/option><option value='Saint-Jean-de-Cherbourg' >Saint-Jean-de-Cherbourg<\/option><option value='Saint-Jean-de-Dieu' >Saint-Jean-de-Dieu<\/option><option value='Saint-Jean-de-Matha' >Saint-Jean-de-Matha<\/option><option value='Saint-Jean-de-l&#039;\u00cele-d&#039;Orl\u00e9ans' >Saint-Jean-de-l&#039;\u00cele-d&#039;Orl\u00e9ans<\/option><option value='Saint-Jean-de-la-Lande' >Saint-Jean-de-la-Lande<\/option><option value='Saint-Jean-sur-Richelieu' >Saint-Jean-sur-Richelieu<\/option><option value='Saint-J\u00e9r\u00f4me' >Saint-J\u00e9r\u00f4me<\/option><option value='Saint-Joachim' >Saint-Joachim<\/option><option value='Saint-Joachim-de-Shefford' >Saint-Joachim-de-Shefford<\/option><option value='Saint-Joseph-de-Beauce' >Saint-Joseph-de-Beauce<\/option><option value='Saint-Joseph-de-Coleraine' >Saint-Joseph-de-Coleraine<\/option><option value='Saint-Joseph-de-Kamouraska' >Saint-Joseph-de-Kamouraska<\/option><option value='Saint-Joseph-de-Lepage' >Saint-Joseph-de-Lepage<\/option><option value='Saint-Joseph-de-Sorel' >Saint-Joseph-de-Sorel<\/option><option value='Saint-Joseph-des-\u00c9rables' >Saint-Joseph-des-\u00c9rables<\/option><option value='Saint-Joseph-du-Lac' >Saint-Joseph-du-Lac<\/option><option value='Saint-Jude' >Saint-Jude<\/option><option value='Saint-Jules' >Saint-Jules<\/option><option value='Saint-Julien' >Saint-Julien<\/option><option value='Saint-Just-de-Breteni\u00e8res' >Saint-Just-de-Breteni\u00e8res<\/option><option value='Saint-Juste-du-Lac' >Saint-Juste-du-Lac<\/option><option value='Saint-Justin' >Saint-Justin<\/option><option value='Saint-Lambert' >Saint-Lambert<\/option><option value='Saint-Lambert-de-Lauzon' >Saint-Lambert-de-Lauzon<\/option><option value='Saint-Laurent-de-l&#039;\u00cele-d&#039;Orl\u00e9ans' >Saint-Laurent-de-l&#039;\u00cele-d&#039;Orl\u00e9ans<\/option><option value='Saint-Lazare' >Saint-Lazare<\/option><option value='Saint-Lazare-de-Bellechasse' >Saint-Lazare-de-Bellechasse<\/option><option value='Saint-L\u00e9andre' >Saint-L\u00e9andre<\/option><option value='Saint-L\u00e9on-de-Standon' >Saint-L\u00e9on-de-Standon<\/option><option value='Saint-L\u00e9on-le-Grand' >Saint-L\u00e9on-le-Grand<\/option><option value='Saint-L\u00e9onard-d&#039;Aston' >Saint-L\u00e9onard-d&#039;Aston<\/option><option value='Saint-L\u00e9onard-de-Portneuf' >Saint-L\u00e9onard-de-Portneuf<\/option><option value='Saint-Liboire' >Saint-Liboire<\/option><option value='Saint-Liguori' >Saint-Liguori<\/option><option value='Saint-Lin--Laurentides' >Saint-Lin&#8211;Laurentides<\/option><option value='Saint-Louis' >Saint-Louis<\/option><option value='Saint-Louis-de-Blandford' >Saint-Louis-de-Blandford<\/option><option value='Saint-Louis-de-Gonzague' >Saint-Louis-de-Gonzague<\/option><option value='Saint-Louis-de-Gonzague-du-Cap-Tourmente' >Saint-Louis-de-Gonzague-du-Cap-Tourmente<\/option><option value='Saint-Louis-du-Ha! Ha!' >Saint-Louis-du-Ha! Ha!<\/option><option value='Saint-Luc-de-Bellechasse' >Saint-Luc-de-Bellechasse<\/option><option value='Saint-Luc-de-Vincennes' >Saint-Luc-de-Vincennes<\/option><option value='Saint-Lucien' >Saint-Lucien<\/option><option value='Saint-Ludger' >Saint-Ludger<\/option><option value='Saint-Ludger-de-Milot' >Saint-Ludger-de-Milot<\/option><option value='Saint-Magloire' >Saint-Magloire<\/option><option value='Saint-Majorique-de-Grantham' >Saint-Majorique-de-Grantham<\/option><option value='Saint-Malachie' >Saint-Malachie<\/option><option value='Saint-Malo' >Saint-Malo<\/option><option value='Saint-Marc-de-Figuery' >Saint-Marc-de-Figuery<\/option><option value='Saint-Marc-des-Carri\u00e8res' >Saint-Marc-des-Carri\u00e8res<\/option><option value='Saint-Marc-du-Lac-Long' >Saint-Marc-du-Lac-Long<\/option><option value='Saint-Marc-sur-Richelieu' >Saint-Marc-sur-Richelieu<\/option><option value='Saint-Marcel' >Saint-Marcel<\/option><option value='Saint-Marcel-de-Richelieu' >Saint-Marcel-de-Richelieu<\/option><option value='Saint-Marcellin' >Saint-Marcellin<\/option><option value='Saint-Martin' >Saint-Martin<\/option><option value='Saint-Mathias-sur-Richelieu' >Saint-Mathias-sur-Richelieu<\/option><option value='Saint-Mathieu' >Saint-Mathieu<\/option><option value='Saint-Mathieu-d&#039;Harricana' >Saint-Mathieu-d&#039;Harricana<\/option><option value='Saint-Mathieu-de-Beloeil' >Saint-Mathieu-de-Beloeil<\/option><option value='Saint-Mathieu-de-Rioux' >Saint-Mathieu-de-Rioux<\/option><option value='Saint-Mathieu-du-Parc' >Saint-Mathieu-du-Parc<\/option><option value='Saint-Maurice' >Saint-Maurice<\/option><option value='Saint-Maxime-du-Mont-Louis' >Saint-Maxime-du-Mont-Louis<\/option><option value='Saint-M\u00e9dard' >Saint-M\u00e9dard<\/option><option value='Saint-Michel' >Saint-Michel<\/option><option value='Saint-Michel-de-Bellechasse' >Saint-Michel-de-Bellechasse<\/option><option value='Saint-Michel-des-Saints' >Saint-Michel-des-Saints<\/option><option value='Saint-Michel-du-Squatec' >Saint-Michel-du-Squatec<\/option><option value='Saint-Modeste' >Saint-Modeste<\/option><option value='Saint-Mo\u00efse' >Saint-Mo\u00efse<\/option><option value='Saint-Narcisse' >Saint-Narcisse<\/option><option value='Saint-Narcisse-de-Beaurivage' >Saint-Narcisse-de-Beaurivage<\/option><option value='Saint-Narcisse-de-Rimouski' >Saint-Narcisse-de-Rimouski<\/option><option value='Saint-Nazaire' >Saint-Nazaire<\/option><option value='Saint-Nazaire-d&#039;Acton' >Saint-Nazaire-d&#039;Acton<\/option><option value='Saint-Nazaire-de-Dorchester' >Saint-Nazaire-de-Dorchester<\/option><option value='Saint-N\u00e9r\u00e9e-de-Bellechasse' >Saint-N\u00e9r\u00e9e-de-Bellechasse<\/option><option value='Saint-No\u00ebl' >Saint-No\u00ebl<\/option><option value='Saint-Norbert' >Saint-Norbert<\/option><option value='Saint-Norbert-d&#039;Arthabaska' >Saint-Norbert-d&#039;Arthabaska<\/option><option value='Saint-Octave-de-M\u00e9tis' >Saint-Octave-de-M\u00e9tis<\/option><option value='Saint-Odilon-de-Cranbourne' >Saint-Odilon-de-Cranbourne<\/option><option value='Saint-Omer' >Saint-Omer<\/option><option value='Saint-On\u00e9sime-d&#039;Ixworth' >Saint-On\u00e9sime-d&#039;Ixworth<\/option><option value='Saint-Ours' >Saint-Ours<\/option><option value='Saint-Pac\u00f4me' >Saint-Pac\u00f4me<\/option><option value='Saint-Pamphile' >Saint-Pamphile<\/option><option value='Saint-Pascal' >Saint-Pascal<\/option><option value='Saint-Patrice-de-Beaurivage' >Saint-Patrice-de-Beaurivage<\/option><option value='Saint-Patrice-de-Sherrington' >Saint-Patrice-de-Sherrington<\/option><option value='Saint-Paul' >Saint-Paul<\/option><option value='Saint-Paul-d&#039;Abbotsford' >Saint-Paul-d&#039;Abbotsford<\/option><option value='Saint-Paul-de-Montminy' >Saint-Paul-de-Montminy<\/option><option value='Saint-Paul-de-l&#039;\u00cele-aux-Noix' >Saint-Paul-de-l&#039;\u00cele-aux-Noix<\/option><option value='Saint-Paul-de-la-Croix' >Saint-Paul-de-la-Croix<\/option><option value='Saint-Paulin' >Saint-Paulin<\/option><option value='Saint-Phil\u00e9mon' >Saint-Phil\u00e9mon<\/option><option value='Saint-Philibert' >Saint-Philibert<\/option><option value='Saint-Philippe' >Saint-Philippe<\/option><option value='Saint-Philippe-de-N\u00e9ri' >Saint-Philippe-de-N\u00e9ri<\/option><option value='Saint-Pie' >Saint-Pie<\/option><option value='Saint-Pie-de-Guire' >Saint-Pie-de-Guire<\/option><option value='Saint-Pierre' >Saint-Pierre<\/option><option value='Saint-Pierre-Baptiste' >Saint-Pierre-Baptiste<\/option><option value='Saint-Pierre-de-Broughton' >Saint-Pierre-de-Broughton<\/option><option value='Saint-Pierre-de-Lamy' >Saint-Pierre-de-Lamy<\/option><option value='Saint-Pierre-de-l&#039;\u00cele-d&#039;Orl\u00e9ans' >Saint-Pierre-de-l&#039;\u00cele-d&#039;Orl\u00e9ans<\/option><option value='Saint-Pierre-de-la-Rivi\u00e8re-du-Sud' >Saint-Pierre-de-la-Rivi\u00e8re-du-Sud<\/option><option value='Saint-Pierre-les-Becquets' >Saint-Pierre-les-Becquets<\/option><option value='Saint-Placide' >Saint-Placide<\/option><option value='Saint-Polycarpe' >Saint-Polycarpe<\/option><option value='Saint-Prime' >Saint-Prime<\/option><option value='Saint-Prosper' >Saint-Prosper<\/option><option value='Saint-Prosper-de-Champlain' >Saint-Prosper-de-Champlain<\/option><option value='Saint-Rapha\u00ebl' >Saint-Rapha\u00ebl<\/option><option value='Saint-Raymond' >Saint-Raymond<\/option><option value='Saint-R\u00e9mi' >Saint-R\u00e9mi<\/option><option value='Saint-R\u00e9mi-de-Tingwick' >Saint-R\u00e9mi-de-Tingwick<\/option><option value='Saint-Ren\u00e9' >Saint-Ren\u00e9<\/option><option value='Saint-Ren\u00e9-de-Matane' >Saint-Ren\u00e9-de-Matane<\/option><option value='Saint-Robert' >Saint-Robert<\/option><option value='Saint-Robert-Bellarmin' >Saint-Robert-Bellarmin<\/option><option value='Saint-Roch-Ouest' >Saint-Roch-Ouest<\/option><option value='Saint-Roch-de-M\u00e9kinac' >Saint-Roch-de-M\u00e9kinac<\/option><option value='Saint-Roch-de-Richelieu' >Saint-Roch-de-Richelieu<\/option><option value='Saint-Roch-de-l&#039;Achigan' >Saint-Roch-de-l&#039;Achigan<\/option><option value='Saint-Roch-des-Aulnaies' >Saint-Roch-des-Aulnaies<\/option><option value='Saint-Romain' >Saint-Romain<\/option><option value='Saint-Rosaire' >Saint-Rosaire<\/option><option value='Saint-Samuel' >Saint-Samuel<\/option><option value='Saint-Sauveur' >Saint-Sauveur<\/option><option value='Saint-S\u00e9bastien' >Saint-S\u00e9bastien<\/option><option value='Saint-S\u00e9v\u00e8re' >Saint-S\u00e9v\u00e8re<\/option><option value='Saint-S\u00e9verin' >Saint-S\u00e9verin<\/option><option value='Saint-Sim\u00e9on' >Saint-Sim\u00e9on<\/option><option value='Saint-Simon' >Saint-Simon<\/option><option value='Saint-Simon-les-Mines' >Saint-Simon-les-Mines<\/option><option value='Saint-Sixte' >Saint-Sixte<\/option><option value='Saint-Stanislas' >Saint-Stanislas<\/option><option value='Saint-Stanislas-de-Kostka' >Saint-Stanislas-de-Kostka<\/option><option value='Saint-Sulpice' >Saint-Sulpice<\/option><option value='Saint-Sylv\u00e8re' >Saint-Sylv\u00e8re<\/option><option value='Saint-Sylvestre' >Saint-Sylvestre<\/option><option value='Saint-T\u00e9lesphore' >Saint-T\u00e9lesphore<\/option><option value='Saint-Tharcisius' >Saint-Tharcisius<\/option><option value='Saint-Th\u00e9odore-d&#039;Acton' >Saint-Th\u00e9odore-d&#039;Acton<\/option><option value='Saint-Th\u00e9ophile' >Saint-Th\u00e9ophile<\/option><option value='Saint-Thomas' >Saint-Thomas<\/option><option value='Saint-Thomas-Didyme' >Saint-Thomas-Didyme<\/option><option value='Saint-Thuribe' >Saint-Thuribe<\/option><option value='Saint-Tite' >Saint-Tite<\/option><option value='Saint-Tite-des-Caps' >Saint-Tite-des-Caps<\/option><option value='Saint-Ubalde' >Saint-Ubalde<\/option><option value='Saint-Ulric' >Saint-Ulric<\/option><option value='Saint-Valentin' >Saint-Valentin<\/option><option value='Saint-Val\u00e8re' >Saint-Val\u00e8re<\/option><option value='Saint-Val\u00e9rien' >Saint-Val\u00e9rien<\/option><option value='Saint-Val\u00e9rien-de-Milton' >Saint-Val\u00e9rien-de-Milton<\/option><option value='Saint-Vallier' >Saint-Vallier<\/option><option value='Saint-Venant-de-Paquette' >Saint-Venant-de-Paquette<\/option><option value='Saint-Vianney' >Saint-Vianney<\/option><option value='Saint-Victor' >Saint-Victor<\/option><option value='Saint-Wenceslas' >Saint-Wenceslas<\/option><option value='Saint-Zacharie' >Saint-Zacharie<\/option><option value='Saint-Z\u00e9non' >Saint-Z\u00e9non<\/option><option value='Saint-Z\u00e9non-du-Lac-Humqui' >Saint-Z\u00e9non-du-Lac-Humqui<\/option><option value='Saint-Z\u00e9phirin-de-Courval' >Saint-Z\u00e9phirin-de-Courval<\/option><option value='Saint-Zotique' >Saint-Zotique<\/option><option value='Sainte-Ad\u00e8le' >Sainte-Ad\u00e8le<\/option><option value='Sainte-Agathe-de-Lotbini\u00e8re' >Sainte-Agathe-de-Lotbini\u00e8re<\/option><option value='Sainte-Agathe-des-Monts' >Sainte-Agathe-des-Monts<\/option><option value='Sainte-Ang\u00e8le-de-M\u00e9rici' >Sainte-Ang\u00e8le-de-M\u00e9rici<\/option><option value='Sainte-Ang\u00e8le-de-Monnoir' >Sainte-Ang\u00e8le-de-Monnoir<\/option><option value='Sainte-Ang\u00e8le-de-Pr\u00e9mont' >Sainte-Ang\u00e8le-de-Pr\u00e9mont<\/option><option value='Sainte-Anne-de-Beaupr\u00e9' >Sainte-Anne-de-Beaupr\u00e9<\/option><option value='Sainte-Anne-de-Bellevue' >Sainte-Anne-de-Bellevue<\/option><option value='Sainte-Anne-de-Sabrevois' >Sainte-Anne-de-Sabrevois<\/option><option value='Sainte-Anne-de-Sorel' >Sainte-Anne-de-Sorel<\/option><option value='Sainte-Anne-de-la-P\u00e9rade' >Sainte-Anne-de-la-P\u00e9rade<\/option><option value='Sainte-Anne-de-la-Pocati\u00e8re' >Sainte-Anne-de-la-Pocati\u00e8re<\/option><option value='Sainte-Anne-de-la-Rochelle' >Sainte-Anne-de-la-Rochelle<\/option><option value='Sainte-Anne-des-Lacs' >Sainte-Anne-des-Lacs<\/option><option value='Sainte-Anne-des-Monts' >Sainte-Anne-des-Monts<\/option><option value='Sainte-Anne-des-Plaines' >Sainte-Anne-des-Plaines<\/option><option value='Sainte-Anne-du-Lac' >Sainte-Anne-du-Lac<\/option><option value='Sainte-Apolline-de-Patton' >Sainte-Apolline-de-Patton<\/option><option value='Sainte-Aur\u00e9lie' >Sainte-Aur\u00e9lie<\/option><option value='Sainte-Barbe' >Sainte-Barbe<\/option><option value='Sainte-B\u00e9atrix' >Sainte-B\u00e9atrix<\/option><option value='Sainte-Brigide-d&#039;Iberville' >Sainte-Brigide-d&#039;Iberville<\/option><option value='Sainte-Brigitte-de-Laval' >Sainte-Brigitte-de-Laval<\/option><option value='Sainte-Brigitte-des-Saults' >Sainte-Brigitte-des-Saults<\/option><option value='Sainte-Catherine' >Sainte-Catherine<\/option><option value='Sainte-Catherine-de-Hatley' >Sainte-Catherine-de-Hatley<\/option><option value='Sainte-Catherine-de-la-Jacques-Cartier' >Sainte-Catherine-de-la-Jacques-Cartier<\/option><option value='Sainte-C\u00e9cile-de-L\u00e9vrard' >Sainte-C\u00e9cile-de-L\u00e9vrard<\/option><option value='Sainte-C\u00e9cile-de-Milton' >Sainte-C\u00e9cile-de-Milton<\/option><option value='Sainte-C\u00e9cile-de-Whitton' >Sainte-C\u00e9cile-de-Whitton<\/option><option value='Sainte-Christine' >Sainte-Christine<\/option><option value='Sainte-Christine-d&#039;Auvergne' >Sainte-Christine-d&#039;Auvergne<\/option><option value='Sainte-Claire' >Sainte-Claire<\/option><option value='Sainte-Clotilde' >Sainte-Clotilde<\/option><option value='Sainte-Clotilde-de-Beauce' >Sainte-Clotilde-de-Beauce<\/option><option value='Sainte-Clotilde-de-Horton' >Sainte-Clotilde-de-Horton<\/option><option value='Sainte-Croix' >Sainte-Croix<\/option><option value='Sainte-Edwidge-de-Clifton' >Sainte-Edwidge-de-Clifton<\/option><option value='Sainte-\u00c9lisabeth' >Sainte-\u00c9lisabeth<\/option><option value='Sainte-\u00c9lizabeth-de-Warwick' >Sainte-\u00c9lizabeth-de-Warwick<\/option><option value='Sainte-\u00c9m\u00e9lie-de-l&#039;\u00c9nergie' >Sainte-\u00c9m\u00e9lie-de-l&#039;\u00c9nergie<\/option><option value='Sainte-Eulalie' >Sainte-Eulalie<\/option><option value='Sainte-Euph\u00e9mie-sur-Rivi\u00e8re-du-Sud' >Sainte-Euph\u00e9mie-sur-Rivi\u00e8re-du-Sud<\/option><option value='Sainte-Famille-de-l\u2019\u00cele-d\u2019Orl\u00e9ans' >Sainte-Famille-de-l\u2019\u00cele-d\u2019Orl\u00e9ans<\/option><option value='Sainte-F\u00e9licit\u00e9' >Sainte-F\u00e9licit\u00e9<\/option><option value='Sainte-Flavie' >Sainte-Flavie<\/option><option value='Sainte-Florence' >Sainte-Florence<\/option><option value='Sainte-Fran\u00e7oise' >Sainte-Fran\u00e7oise<\/option><option value='Sainte-Genevi\u00e8ve-de-Batiscan' >Sainte-Genevi\u00e8ve-de-Batiscan<\/option><option value='Sainte-Genevi\u00e8ve-de-Berthier' >Sainte-Genevi\u00e8ve-de-Berthier<\/option><option value='Sainte-Germaine-Boul\u00e9' >Sainte-Germaine-Boul\u00e9<\/option><option value='Sainte-Gertrude-Manneville' >Sainte-Gertrude-Manneville<\/option><option value='Sainte-Hedwidge' >Sainte-Hedwidge<\/option><option value='Sainte-H\u00e9l\u00e8ne-de-Bagot' >Sainte-H\u00e9l\u00e8ne-de-Bagot<\/option><option value='Sainte-H\u00e9l\u00e8ne-de-Chester' >Sainte-H\u00e9l\u00e8ne-de-Chester<\/option><option value='Sainte-H\u00e9l\u00e8ne-de-Kamouraska' >Sainte-H\u00e9l\u00e8ne-de-Kamouraska<\/option><option value='Sainte-H\u00e9l\u00e8ne-de-Mancebourg' >Sainte-H\u00e9l\u00e8ne-de-Mancebourg<\/option><option value='Sainte-H\u00e9n\u00e9dine' >Sainte-H\u00e9n\u00e9dine<\/option><option value='Sainte-Ir\u00e8ne' >Sainte-Ir\u00e8ne<\/option><option value='Sainte-Jeanne-d&#039;Arc' >Sainte-Jeanne-d&#039;Arc<\/option><option value='Sainte-Julie' >Sainte-Julie<\/option><option value='Sainte-Julienne' >Sainte-Julienne<\/option><option value='Sainte-Justine' >Sainte-Justine<\/option><option value='Sainte-Justine-de-Newton' >Sainte-Justine-de-Newton<\/option><option value='Sainte-Louise' >Sainte-Louise<\/option><option value='Sainte-Luce' >Sainte-Luce<\/option><option value='Sainte-Lucie-de-Beauregard' >Sainte-Lucie-de-Beauregard<\/option><option value='Sainte-Lucie-des-Laurentides' >Sainte-Lucie-des-Laurentides<\/option><option value='Sainte-Madeleine' >Sainte-Madeleine<\/option><option value='Sainte-Madeleine-de-la-Rivi\u00e8re-Madeleine' >Sainte-Madeleine-de-la-Rivi\u00e8re-Madeleine<\/option><option value='Sainte-Marcelline-de-Kildare' >Sainte-Marcelline-de-Kildare<\/option><option value='Sainte-Marguerite' >Sainte-Marguerite<\/option><option value='Sainte-Marguerite-Marie' >Sainte-Marguerite-Marie<\/option><option value='Sainte-Marguerite-du-Lac-Masson' >Sainte-Marguerite-du-Lac-Masson<\/option><option value='Sainte-Marie' >Sainte-Marie<\/option><option value='Sainte-Marie-Madeleine' >Sainte-Marie-Madeleine<\/option><option value='Sainte-Marie-Salom\u00e9' >Sainte-Marie-Salom\u00e9<\/option><option value='Sainte-Marie-de-Blandford' >Sainte-Marie-de-Blandford<\/option><option value='Sainte-Marthe' >Sainte-Marthe<\/option><option value='Sainte-Marthe-sur-le-Lac' >Sainte-Marthe-sur-le-Lac<\/option><option value='Sainte-Martine' >Sainte-Martine<\/option><option value='Sainte-M\u00e9lanie' >Sainte-M\u00e9lanie<\/option><option value='Sainte-Monique' >Sainte-Monique<\/option><option value='Sainte-Paule' >Sainte-Paule<\/option><option value='Sainte-Perp\u00e9tue' >Sainte-Perp\u00e9tue<\/option><option value='Sainte-P\u00e9tronille' >Sainte-P\u00e9tronille<\/option><option value='Sainte-Prax\u00e8de' >Sainte-Prax\u00e8de<\/option><option value='Sainte-Rita' >Sainte-Rita<\/option><option value='Sainte-Rose-de-Watford' >Sainte-Rose-de-Watford<\/option><option value='Sainte-Rose-du-Nord' >Sainte-Rose-du-Nord<\/option><option value='Sainte-Sabine' >Sainte-Sabine<\/option><option value='Sainte-S\u00e9raphine' >Sainte-S\u00e9raphine<\/option><option value='Sainte-Sophie' >Sainte-Sophie<\/option><option value='Sainte-Sophie-d&#039;Halifax' >Sainte-Sophie-d&#039;Halifax<\/option><option value='Sainte-Sophie-de-L\u00e9vrard' >Sainte-Sophie-de-L\u00e9vrard<\/option><option value='Sainte-Th\u00e8cle' >Sainte-Th\u00e8cle<\/option><option value='Sainte-Th\u00e9r\u00e8se' >Sainte-Th\u00e9r\u00e8se<\/option><option value='Sainte-Th\u00e9r\u00e8se-de-Gasp\u00e9' >Sainte-Th\u00e9r\u00e8se-de-Gasp\u00e9<\/option><option value='Sainte-Th\u00e9r\u00e8se-de-la-Gatineau' >Sainte-Th\u00e9r\u00e8se-de-la-Gatineau<\/option><option value='Sainte-Ursule' >Sainte-Ursule<\/option><option value='Sainte-Victoire-de-Sorel' >Sainte-Victoire-de-Sorel<\/option><option value='Saints-Anges' >Saints-Anges<\/option><option value='Saints-Martyrs-Canadiens' >Saints-Martyrs-Canadiens<\/option><option value='Salaberry-de-Valleyfield' >Salaberry-de-Valleyfield<\/option><option value='Salluit' >Salluit<\/option><option value='Sayabec' >Sayabec<\/option><option value='Schefferville' >Schefferville<\/option><option value='Scotstown' >Scotstown<\/option><option value='Scott' >Scott<\/option><option value='Senneterre' >Senneterre<\/option><option value='Senneville' >Senneville<\/option><option value='Sept-\u00celes' >Sept-\u00celes<\/option><option value='Sept-Rivi\u00e8res' >Sept-Rivi\u00e8res<\/option><option value='Shannon' >Shannon<\/option><option value='Shawinigan' >Shawinigan<\/option><option value='Shawville' >Shawville<\/option><option value='Sheenboro' >Sheenboro<\/option><option value='Shefford' >Shefford<\/option><option value='Sherbrooke' >Sherbrooke<\/option><option value='Shigawake' >Shigawake<\/option><option value='Sorel-Tracy' >Sorel-Tracy<\/option><option value='Stanbridge East' >Stanbridge East<\/option><option value='Stanbridge Station' >Stanbridge Station<\/option><option value='Stanstead' >Stanstead<\/option><option value='Stanstead-Est' >Stanstead-Est<\/option><option value='Stoke' >Stoke<\/option><option value='Stoneham-et-Tewkesbury' >Stoneham-et-Tewkesbury<\/option><option value='Stornoway' >Stornoway<\/option><option value='Stratford' >Stratford<\/option><option value='Stukely-Sud' >Stukely-Sud<\/option><option value='Sutton' >Sutton<\/option><option value='Tadoussac' >Tadoussac<\/option><option value='Taschereau' >Taschereau<\/option><option value='Tasiujaq' >Tasiujaq<\/option><option value='T\u00e9miscaming' >T\u00e9miscaming<\/option><option value='T\u00e9miscamingue' >T\u00e9miscamingue<\/option><option value='T\u00e9miscouata' >T\u00e9miscouata<\/option><option value='T\u00e9miscouata-sur-le-Lac' >T\u00e9miscouata-sur-le-Lac<\/option><option value='Terrasse-Vaudreuil' >Terrasse-Vaudreuil<\/option><option value='Terrebonne' >Terrebonne<\/option><option value='Th\u00e9r\u00e8se-De Blainville' >Th\u00e9r\u00e8se-De Blainville<\/option><option value='Thetford Mines' >Thetford Mines<\/option><option value='Thorne' >Thorne<\/option><option value='Thurso' >Thurso<\/option><option value='Tingwick' >Tingwick<\/option><option value='Tourville' >Tourville<\/option><option value='Tr\u00e9cesson' >Tr\u00e9cesson<\/option><option value='Tr\u00e8s-Saint-R\u00e9dempteur' >Tr\u00e8s-Saint-R\u00e9dempteur<\/option><option value='Tr\u00e8s-Saint-Sacrement' >Tr\u00e8s-Saint-Sacrement<\/option><option value='Tring-Jonction' >Tring-Jonction<\/option><option value='Trois-Pistoles' >Trois-Pistoles<\/option><option value='Trois-Rives' >Trois-Rives<\/option><option value='Trois-Rivi\u00e8res' >Trois-Rivi\u00e8res<\/option><option value='Ulverton' >Ulverton<\/option><option value='Umiujaq' >Umiujaq<\/option><option value='Upton' >Upton<\/option><option value='Val-Alain' >Val-Alain<\/option><option value='Val-Brillant' >Val-Brillant<\/option><option value='Val-David' >Val-David<\/option><option value='Val-Joli' >Val-Joli<\/option><option value='Val-Morin' >Val-Morin<\/option><option value='Val-Racine' >Val-Racine<\/option><option value='Val-Saint-Gilles' >Val-Saint-Gilles<\/option><option value='Val-d&#039;Or' >Val-d&#039;Or<\/option><option value='Val-des-Bois' >Val-des-Bois<\/option><option value='Val-des-Lacs' >Val-des-Lacs<\/option><option value='Val-des-Monts' >Val-des-Monts<\/option><option value='Valcourt' >Valcourt<\/option><option value='Valcourt' >Valcourt<\/option><option value='Vall\u00e9e-Jonction' >Vall\u00e9e-Jonction<\/option><option value='Varennes' >Varennes<\/option><option value='Vaudreuil-Dorion' >Vaudreuil-Dorion<\/option><option value='Vaudreuil-Soulanges' >Vaudreuil-Soulanges<\/option><option value='Vaudreuil-sur-le-Lac' >Vaudreuil-sur-le-Lac<\/option><option value='Venise-en-Qu\u00e9bec' >Venise-en-Qu\u00e9bec<\/option><option value='Verch\u00e8res' >Verch\u00e8res<\/option><option value='Victoriaville' >Victoriaville<\/option><option value='Ville-Marie' >Ville-Marie<\/option><option value='Villeroy' >Villeroy<\/option><option value='Waltham' >Waltham<\/option><option value='Warden' >Warden<\/option><option value='Warwick' >Warwick<\/option><option value='Waskaganish' >Waskaganish<\/option><option value='Waswanipi' >Waswanipi<\/option><option value='Waterloo' >Waterloo<\/option><option value='Waterville' >Waterville<\/option><option value='Weedon' >Weedon<\/option><option value='Wemindji' >Wemindji<\/option><option value='Wentworth' >Wentworth<\/option><option value='Wentworth-Nord' >Wentworth-Nord<\/option><option value='Westbury' >Westbury<\/option><option value='Westmount' >Westmount<\/option><option value='Whapmagoostui' >Whapmagoostui<\/option><option value='Wickham' >Wickham<\/option><option value='Windsor' >Windsor<\/option><option value='Wotton' >Wotton<\/option><option value='Yamachiche' >Yamachiche<\/option><option value='Yamaska' >Yamaska<\/option><\/select><\/div><\/div><fieldset id=\"field_2_145\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >4T &#8211; R\u00e9gion de la violence, Ville<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_145'><div class='gchoice gchoice_2_145_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_145.1' type='checkbox'  value='Je pr\u00e9f\u00e8re ne pas r\u00e9pondre'  id='choice_2_145_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_145_1' id='label_2_145_1' class='gform-field-label gform-field-label--type-inline'>I prefer not to answer<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_2_118' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Back'  \/> <input type='button' id='gform_next_button_2_118' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_2_5' class='gform_page' data-js='page-field-id-118' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_2_5' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_2_94\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">5. IDENTIFICATION OF THE PERPETRATOR(S)<\/h3><\/div><div id=\"field_2_95\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">How many people do you identify as perpetrators of this violence or abuse?*<\/h3><\/div><fieldset id=\"field_2_96\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >5T &#8211; Nombre de personne<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_2_96'>\n\t\t\t<div class='gchoice gchoice_2_96_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_96' type='radio' value='Une personne'  id='choice_2_96_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_96_0' id='label_2_96_0' class='gform-field-label gform-field-label--type-inline'>One person<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_96_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_96' type='radio' value='Plusieurs personnes'  id='choice_2_96_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_96_1' id='label_2_96_1' class='gform-field-label gform-field-label--type-inline'>Several people<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_96_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_96' type='radio' value='Une institution ou un syst\u00e8me de la soci\u00e9t\u00e9'  id='choice_2_96_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_96_2' id='label_2_96_2' class='gform-field-label gform-field-label--type-inline'>An institution or a system<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_98\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">One person<\/h3><div class='mm_tooltip_text' style='display:none'><p>Si la situation implique plusieurs personnes victimes, s\u00e9lectionne la ou les relations entre la personne auteure et chaque personne victime.<\/p><\/div><\/div><div id=\"field_2_147\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Select the answer(s) that best describe this person*<\/h3><div class='gsection_description' id='gfield_description_2_147'>You can select more than one option.  If the situation has more than one victim, select the relationship(s) between the perpetrator and each victim <\/div><\/div><fieldset id=\"field_2_97\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >5T &#8211; Une personne<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_2_97'><div class='gchoice gchoice_2_97_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.1' type='checkbox'  value='Membre de la famille de la personne victime'  id='choice_2_97_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_1' id='label_2_97_1' class='gform-field-label gform-field-label--type-inline'>A member of the victim\u2019s family <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_97_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.2' type='checkbox'  value='Qui d\u00e9tient une autorit\u00e9 parentale ou l\u00e9gale sur la personne victime'  id='choice_2_97_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_2' id='label_2_97_2' class='gform-field-label gform-field-label--type-inline'>Someone who has parental or legal authority over them<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_97_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.3' type='checkbox'  value='Envers qui la personne victime a une responsabilit\u00e9 parentale ou l\u00e9gale'  id='choice_2_97_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_3' id='label_2_97_3' class='gform-field-label gform-field-label--type-inline'>Someone towards whom they have a parental or legal authority<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_97_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.4' type='checkbox'  value='Avec qui elle est en relation d\u2019amiti\u00e9'  id='choice_2_97_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_4' id='label_2_97_4' class='gform-field-label gform-field-label--type-inline'>A friend<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_97_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.5' type='checkbox'  value='Avec qui la personne victime a \u00e9t\u00e9 en relation d&#039;amiti\u00e9 par le pass\u00e9'  id='choice_2_97_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_5' id='label_2_97_5' class='gform-field-label gform-field-label--type-inline'>Someone they were friend with prior to the violence situation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_97_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.6' type='checkbox'  value='Avec qui elle est en relation intime, amoureuse ou sexuelle'  id='choice_2_97_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_6' id='label_2_97_6' class='gform-field-label gform-field-label--type-inline'>Someone with whom they are in a loving, intimate or sexual relationship<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_97_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.7' type='checkbox'  value='Avec qui la personne victime a \u00e9t\u00e9 en relation intime, amoureuse ou sexuelle par le pass\u00e9'  id='choice_2_97_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_7' id='label_2_97_7' class='gform-field-label gform-field-label--type-inline'>Someone with whom they used to be in a loving, intimate or sexual relationship prior to the violent situation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_97_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.8' type='checkbox'  value='Avec qui la personne victime a eu des enfants'  id='choice_2_97_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_8' id='label_2_97_8' class='gform-field-label gform-field-label--type-inline'>Someone with whom they have kid(s)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_97_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.9' type='checkbox'  value='Avec qui elle est en colocation'  id='choice_2_97_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_9' id='label_2_97_9' class='gform-field-label gform-field-label--type-inline'>Roommate<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_97_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.11' type='checkbox'  value='Chez qui la personne victime est h\u00e9berg\u00e9e ou avec qui elle demeure actuellement'  id='choice_2_97_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_11' id='label_2_97_11' class='gform-field-label gform-field-label--type-inline'>Someone who currently hosts them<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_97_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.12' type='checkbox'  value='Qui est propri\u00e9taire de l&#039;endroit o\u00f9 la personne victime r\u00e9side actuellement'  id='choice_2_97_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_12' id='label_2_97_12' class='gform-field-label gform-field-label--type-inline'>A property owner or manager<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_97_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.13' type='checkbox'  value='Qu\u2019elle c\u00f4toie au travail'  id='choice_2_97_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_13' id='label_2_97_13' class='gform-field-label gform-field-label--type-inline'>Someone they&#8217;re seeing at work<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_97_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.14' type='checkbox'  value='Qui la supervise dans le cadre du travail'  id='choice_2_97_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_14' id='label_2_97_14' class='gform-field-label gform-field-label--type-inline'>Someone who supervises them at work<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_97_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.15' type='checkbox'  value='Qu\u2019elle c\u00f4toie \u00e0 l\u2019\u00e9cole'  id='choice_2_97_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_15' id='label_2_97_15' class='gform-field-label gform-field-label--type-inline'>Someone they are seeing at school<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_97_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.16' type='checkbox'  value='Qui travaille dans un \u00e9tablissement d\u2019enseignement'  id='choice_2_97_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_16' id='label_2_97_16' class='gform-field-label gform-field-label--type-inline'>Someone who works in an educational institution<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_97_17'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.17' type='checkbox'  value='Qui travaille dans le domaine de la sant\u00e9 et des services sociaux'  id='choice_2_97_17'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_17' id='label_2_97_17' class='gform-field-label gform-field-label--type-inline'>Someone who works in health and social services<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_97_18'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.18' type='checkbox'  value='Qui travaille dans le milieu communautaire'  id='choice_2_97_18'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_18' id='label_2_97_18' class='gform-field-label gform-field-label--type-inline'>Someone who works in a community organization<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_97_19'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.19' type='checkbox'  value='Qui travaille dans le domaine juridique'  id='choice_2_97_19'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_19' id='label_2_97_19' class='gform-field-label gform-field-label--type-inline'>Someone who works in the legal or judicial field<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_97_21'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.21' type='checkbox'  value='Qui travaille dans le domaine sportif'  id='choice_2_97_21'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_21' id='label_2_97_21' class='gform-field-label gform-field-label--type-inline'>Someone who works in the sports field<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_97_22'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.22' type='checkbox'  value='Qui travaille dans les forces de police'  id='choice_2_97_22'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_22' id='label_2_97_22' class='gform-field-label gform-field-label--type-inline'>Someone who works for the police<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_97_23'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.23' type='checkbox'  value='Qui travaille en politique'  id='choice_2_97_23'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_23' id='label_2_97_23' class='gform-field-label gform-field-label--type-inline'>Someone who works in politics\/is an elected official<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_97_24'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.24' type='checkbox'  value='Connue du public'  id='choice_2_97_24'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_24' id='label_2_97_24' class='gform-field-label gform-field-label--type-inline'>A public figure<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_97_25'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.25' type='checkbox'  value='Inconnue ou que la personne victime conna\u00eet peu'  id='choice_2_97_25'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_25' id='label_2_97_25' class='gform-field-label gform-field-label--type-inline'>A stranger or someone they don&#8217;t really know<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_97_26'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.26' type='checkbox'  value='Je ne sais pas'  id='choice_2_97_26'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_26' id='label_2_97_26' class='gform-field-label gform-field-label--type-inline'>I do not know<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_97_27'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.27' type='checkbox'  value='Autre (pr\u00e9ciser)'  id='choice_2_97_27'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_27' id='label_2_97_27' class='gform-field-label gform-field-label--type-inline'>Other(s) (Please specify)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_97_28'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_97.28' type='checkbox'  value='Je pr\u00e9f\u00e8re ne pas r\u00e9pondre'  id='choice_2_97_28'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_97_28' id='label_2_97_28' class='gform-field-label gform-field-label--type-inline'>I prefer not to answer<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='mm_tooltip_text' style='display:none'><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><p>FR : Par exemple, membre du personnel enseignant, membre de la direction, etc. | EN : For example a teacher, a principal, etc.<\/p><hr \/><p>FR : Par exemple, m\u00e9decin, membre du personnel infirmier, personne pr\u00e9pos\u00e9e aux b\u00e9n\u00e9ficiaires, etc. | EN : For example a doctor, a nurse, a medical secretary, etc.<\/p><hr \/><p>FR : Par exemple, membre du personnel intervenant dans un organisme communautaire, etc. | EN : For example a counsellor affiliated to a community organization<\/p><hr \/><p>FR : Par exemple, personne avocate, juge, procureure, douani\u00e8re, etc. | EN : For example a lawyer, a judge, a customs agent, etc.<\/p><\/div><\/fieldset><div id=\"field_2_106\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_106'>Other(s)<\/label><div class='ginput_container ginput_container_text'><input name='input_106' id='input_2_106' type='text' value='' class='large' maxlength='350'     aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_99\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Do you consider that the perpetrator was in a position of authority over the victim or at least one of the victims? <\/h3><\/div><fieldset id=\"field_2_100\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >5T &#8211; Une personne, Position d&#039;autorit\u00e9<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_100'>\n\t\t\t<div class='gchoice gchoice_2_100_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_100' type='radio' value='Oui (pr\u00e9ciser)'  id='choice_2_100_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_100_0' id='label_2_100_0' class='gform-field-label gform-field-label--type-inline'>Yes (Please specify)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_100_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_100' type='radio' value='Non'  id='choice_2_100_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_100_1' id='label_2_100_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_100_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_100' type='radio' value='Je ne sais pas'  id='choice_2_100_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_100_2' id='label_2_100_2' class='gform-field-label gform-field-label--type-inline'>I do not know<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_100_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_100' type='radio' value='Je pr\u00e9f\u00e8re ne pas r\u00e9pondre'  id='choice_2_100_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_100_3' id='label_2_100_3' class='gform-field-label gform-field-label--type-inline'>I prefer not to answer<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_116\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_116'>Please specify if your answer is yes<\/label><div class='ginput_container ginput_container_text'><input name='input_116' id='input_2_116' type='text' value='' class='large' maxlength='350'     aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_101\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Which of these categories best correspond to the known or approximate age of the perpetrator? <\/h3><\/div><fieldset id=\"field_2_105\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >5T &#8211; Une personne, \u00c2ge<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_105'>\n\t\t\t<div class='gchoice gchoice_2_105_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_105' type='radio' value='Moins de 12 ans'  id='choice_2_105_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_105_0' id='label_2_105_0' class='gform-field-label gform-field-label--type-inline'>Under 12 years old<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_105_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_105' type='radio' value='Entre 12 et 17 ans'  id='choice_2_105_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_105_1' id='label_2_105_1' class='gform-field-label gform-field-label--type-inline'>12 to 17 years old<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_105_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_105' type='radio' value='Entre 18 et 30 ans'  id='choice_2_105_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_105_2' id='label_2_105_2' class='gform-field-label gform-field-label--type-inline'>18 to 30 years old<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_105_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_105' type='radio' value='Entre 31 et 59 ans'  id='choice_2_105_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_105_3' id='label_2_105_3' class='gform-field-label gform-field-label--type-inline'>31 to 59 years old<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_105_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_105' type='radio' value='60 ans et plus'  id='choice_2_105_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_105_4' id='label_2_105_4' class='gform-field-label gform-field-label--type-inline'>60 years old and over<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_105_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_105' type='radio' value='Je ne sais pas'  id='choice_2_105_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_105_5' id='label_2_105_5' class='gform-field-label gform-field-label--type-inline'>I do not know<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_103\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Does the perpetrator identify as an LGBTQI+ person? <\/h3><\/div><fieldset id=\"field_2_104\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >5T &#8211; Une personne, LGBTQI+<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_104'>\n\t\t\t<div class='gchoice gchoice_2_104_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_104' type='radio' value='Oui, je sais que cette personne fait partie des communaut\u00e9s LGBTQI+'  id='choice_2_104_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_104_0' id='label_2_104_0' class='gform-field-label gform-field-label--type-inline'>Yes, I know that this person identifies as an LGBTQI+ person <\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_104_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_104' type='radio' value='Non, je sais que cette personne n\u2019en fait pas partie'  id='choice_2_104_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_104_1' id='label_2_104_1' class='gform-field-label gform-field-label--type-inline'>No, I know that this person does not identify as an LGBTQI+ person<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_104_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_104' type='radio' value='Je ne sais pas'  id='choice_2_104_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_104_2' id='label_2_104_2' class='gform-field-label gform-field-label--type-inline'>I do not know<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_104_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_104' type='radio' value='Je pr\u00e9f\u00e8re ne pas r\u00e9pondre'  id='choice_2_104_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_104_3' id='label_2_104_3' class='gform-field-label gform-field-label--type-inline'>I prefer not to answer<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_107\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Several people<\/h3><div class='mm_tooltip_text' style='display:none'><p>Si la situation implique plusieurs personnes victimes, s\u00e9lectionne la ou les relations entre chaque personne auteure et chaque personne victime.<\/p><\/div><\/div><div id=\"field_2_111\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Enter the number of people you identify as perpetrators of this violence or abuse?<\/h3><\/div><div id=\"field_2_110\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_110'>5T &#8211; Plusieurs personnes, Nombre<\/label><div class='ginput_container ginput_container_number'><input name='input_110' id='input_2_110' type='number' step='any' min='2'  value='' class='large'      aria-invalid=\"false\" aria-describedby=\"gfield_instruction_2_110\" \/><div class='gfield_description instruction ' id='gfield_instruction_2_110'>Please enter a number greater than or equal to <strong>2<\/strong>.<\/div><\/div><\/div><div id=\"field_2_146\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Select the answer(s) that best describe these people*<\/h3><div class='gsection_description' id='gfield_description_2_146'>You can select more than one option.  \r\nIf the situation has more than one victim, select the relation(s) between each perpetrator and each victim <\/div><\/div><fieldset id=\"field_2_108\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >5T &#8211; Plusieurs personnes<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_2_108'><div class='gchoice gchoice_2_108_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.1' type='checkbox'  value='Membres de la famille de la personne victime'  id='choice_2_108_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_1' id='label_2_108_1' class='gform-field-label gform-field-label--type-inline'>Member(s) of the victim\u2019s family <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_108_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.2' type='checkbox'  value='qui d\u00e9tiennent une autorit\u00e9 parentale ou l\u00e9gale sur la personne victime'  id='choice_2_108_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_2' id='label_2_108_2' class='gform-field-label gform-field-label--type-inline'>People who has parental or legal authority over them<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_108_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.3' type='checkbox'  value='Envers qui la personne victime a une responsabilit\u00e9 parentale ou l\u00e9gale'  id='choice_2_108_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_3' id='label_2_108_3' class='gform-field-label gform-field-label--type-inline'>People towards whom they have a parental or legal authority<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_108_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.4' type='checkbox'  value='Avec qui elle est en relation d\u2019amiti\u00e9'  id='choice_2_108_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_4' id='label_2_108_4' class='gform-field-label gform-field-label--type-inline'>Friends<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_108_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.5' type='checkbox'  value='Avec qui elle \u00e9tait en relation d&#039;amiti\u00e9 par le pass\u00e9'  id='choice_2_108_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_5' id='label_2_108_5' class='gform-field-label gform-field-label--type-inline'>People they were friend with prior to the violence situation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_108_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.6' type='checkbox'  value='Avec qui elle est en relation intime, amoureuse ou sexuelle'  id='choice_2_108_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_6' id='label_2_108_6' class='gform-field-label gform-field-label--type-inline'>People with whom they are in a loving, intimate or sexual relationship<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_108_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.7' type='checkbox'  value='Avec qui elle \u00e9tait en relation intime, amoureuse ou sexuelle par le pass\u00e9'  id='choice_2_108_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_7' id='label_2_108_7' class='gform-field-label gform-field-label--type-inline'>People with whom they used to be in a loving, intimate or sexual relationship prior to the violent situation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_108_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.8' type='checkbox'  value='Avec qui la personne victime a eu des enfants'  id='choice_2_108_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_8' id='label_2_108_8' class='gform-field-label gform-field-label--type-inline'>People with whom they have kid(s)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_108_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.9' type='checkbox'  value='Avec qui elle est en colocation'  id='choice_2_108_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_9' id='label_2_108_9' class='gform-field-label gform-field-label--type-inline'>Roommates<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_108_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.11' type='checkbox'  value='Chez qui la personne victime demeure actuellement ou qui l&#039;h\u00e9bergent'  id='choice_2_108_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_11' id='label_2_108_11' class='gform-field-label gform-field-label--type-inline'>People who currently hosts them<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_108_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.12' type='checkbox'  value='qui sont propri\u00e9taires de la r\u00e9sidence de la personne victime'  id='choice_2_108_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_12' id='label_2_108_12' class='gform-field-label gform-field-label--type-inline'>Property owners or managers<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_108_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.13' type='checkbox'  value='Qu\u2019elle c\u00f4toie au travail'  id='choice_2_108_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_13' id='label_2_108_13' class='gform-field-label gform-field-label--type-inline'>People who supervises them at work<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_108_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.14' type='checkbox'  value='Qui la supervisent dans le cadre du travail'  id='choice_2_108_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_14' id='label_2_108_14' class='gform-field-label gform-field-label--type-inline'>People who supervises them at work<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_108_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.15' type='checkbox'  value='Qu\u2019elle c\u00f4toie \u00e0 l\u2019\u00e9cole'  id='choice_2_108_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_15' id='label_2_108_15' class='gform-field-label gform-field-label--type-inline'>People they are seeing at school<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_108_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.16' type='checkbox'  value='Qui travaillent dans un \u00e9tablissement d\u2019enseignement'  id='choice_2_108_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_16' id='label_2_108_16' class='gform-field-label gform-field-label--type-inline'>People working in a school setting<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_108_17'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.17' type='checkbox'  value='Qui travaillent dans le domaine de la sant\u00e9 et des services sociaux'  id='choice_2_108_17'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_17' id='label_2_108_17' class='gform-field-label gform-field-label--type-inline'>People working in healthcare or social work<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_108_18'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.18' type='checkbox'  value='Qui travaillent dans le milieu communautaire'  id='choice_2_108_18'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_18' id='label_2_108_18' class='gform-field-label gform-field-label--type-inline'>People working in community organizations<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_108_19'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.19' type='checkbox'  value='Qui travaillent dans le domaine juridique'  id='choice_2_108_19'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_19' id='label_2_108_19' class='gform-field-label gform-field-label--type-inline'>People working in judicial or legal fields<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_108_21'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.21' type='checkbox'  value='Qui travaillent dans le domaine sportif'  id='choice_2_108_21'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_21' id='label_2_108_21' class='gform-field-label gform-field-label--type-inline'>People working in sports fields<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_108_22'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.22' type='checkbox'  value='Qui travaillent dans les forces de police'  id='choice_2_108_22'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_22' id='label_2_108_22' class='gform-field-label gform-field-label--type-inline'>People working in the police<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_108_23'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.23' type='checkbox'  value='Qui travaillent en politique'  id='choice_2_108_23'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_23' id='label_2_108_23' class='gform-field-label gform-field-label--type-inline'>Politicians and elected officials<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_108_24'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.24' type='checkbox'  value='Connues du public'  id='choice_2_108_24'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_24' id='label_2_108_24' class='gform-field-label gform-field-label--type-inline'>Public personalities<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_108_25'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.25' type='checkbox'  value='Inconnues ou que la personne victime conna\u00eet peu'  id='choice_2_108_25'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_25' id='label_2_108_25' class='gform-field-label gform-field-label--type-inline'>Strangers or people they don&#8217;t really know<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_108_26'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.26' type='checkbox'  value='Je ne sais pas'  id='choice_2_108_26'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_26' id='label_2_108_26' class='gform-field-label gform-field-label--type-inline'>I do not know<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_108_27'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.27' type='checkbox'  value='Autres (pr\u00e9ciser)'  id='choice_2_108_27'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_27' id='label_2_108_27' class='gform-field-label gform-field-label--type-inline'>Other(s) (Please specify)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_108_28'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.28' type='checkbox'  value='Je pr\u00e9f\u00e8re ne pas r\u00e9pondre'  id='choice_2_108_28'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_108_28' id='label_2_108_28' class='gform-field-label gform-field-label--type-inline'>I prefer not to answer<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='mm_tooltip_text' style='display:none'><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><hr \/><p>FR : Par exemple, membre du personnel enseignant, membre de la direction, etc. | EN : For example a teacher, a principal, etc.<\/p><hr \/><p>FR : Par exemple, m\u00e9decin, membre du personnel infirmier, personne pr\u00e9pos\u00e9e aux b\u00e9n\u00e9ficiaires, etc. | EN : For example a doctor, a nurse, a medical secretary, etc.<\/p><hr \/><p>FR : Par exemple, membre du personnel intervenant dans un organisme communautaire, etc. | EN : For example a counsellor affiliated to a community organization<\/p><hr \/><p>FR : Par exemple, personne avocate, juge, procureure, douani\u00e8re, etc. | EN : For example a lawyer, a judge, a customs agent, etc.<\/p><\/div><\/fieldset><div id=\"field_2_109\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_109'>Other(s)<\/label><div class='ginput_container ginput_container_text'><input name='input_109' id='input_2_109' type='text' value='' class='large' maxlength='350'     aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_112\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Do you consider that at least one of these people was in a position of authority over at least one of the victims?  <\/h3><\/div><fieldset id=\"field_2_113\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >5T &#8211; Plusieurs personne, Position d&#039;autorit\u00e9<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_113'>\n\t\t\t<div class='gchoice gchoice_2_113_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_113' type='radio' value='Oui (pr\u00e9ciser)'  id='choice_2_113_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_113_0' id='label_2_113_0' class='gform-field-label gform-field-label--type-inline'>Yes (Please specify)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_113_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_113' type='radio' value='Non'  id='choice_2_113_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_113_1' id='label_2_113_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_113_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_113' type='radio' value='Je ne sais pas'  id='choice_2_113_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_113_2' id='label_2_113_2' class='gform-field-label gform-field-label--type-inline'>I do not know<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_113_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_113' type='radio' value='Je pr\u00e9f\u00e8re ne pas r\u00e9pondre'  id='choice_2_113_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_113_3' id='label_2_113_3' class='gform-field-label gform-field-label--type-inline'>I prefer not to answer<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_114\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_114'>Please specify if your answer is yes<\/label><div class='ginput_container ginput_container_text'><input name='input_114' id='input_2_114' type='text' value='' class='large' maxlength='350'     aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_119\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">An institution or a system*<\/h3><\/div><fieldset id=\"field_2_120\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >5T &#8211; Une institution ou un syst\u00e8me de la soci\u00e9t\u00e9<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_2_120'><div class='gchoice gchoice_2_120_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.1' type='checkbox'  value='R\u00e9seau de la sant\u00e9 et des services sociaux'  id='choice_2_120_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_120_1' id='label_2_120_1' class='gform-field-label gform-field-label--type-inline'>Health system and social services <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_120_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.2' type='checkbox'  value='R\u00e9seau de l\u2019\u00e9ducation'  id='choice_2_120_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_120_2' id='label_2_120_2' class='gform-field-label gform-field-label--type-inline'>Education system <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_120_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.3' type='checkbox'  value='Syst\u00e8me de loisirs publics'  id='choice_2_120_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_120_3' id='label_2_120_3' class='gform-field-label gform-field-label--type-inline'>Public recreation system <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_120_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.4' type='checkbox'  value='Syst\u00e8me de services priv\u00e9s'  id='choice_2_120_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_120_4' id='label_2_120_4' class='gform-field-label gform-field-label--type-inline'>Private service system <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_120_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.5' type='checkbox'  value='Syst\u00e8mes l\u00e9gal et judiciaire'  id='choice_2_120_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_120_5' id='label_2_120_5' class='gform-field-label gform-field-label--type-inline'>Legal system<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_120_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.6' type='checkbox'  value='Gouvernement ou parti politique'  id='choice_2_120_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_120_6' id='label_2_120_6' class='gform-field-label gform-field-label--type-inline'>Political system, political parties or government<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_120_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.7' type='checkbox'  value='Forces arm\u00e9es canadiennes'  id='choice_2_120_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_120_7' id='label_2_120_7' class='gform-field-label gform-field-label--type-inline'>Canadian Armed Forces<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_120_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.8' type='checkbox'  value='Les services de police'  id='choice_2_120_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_120_8' id='label_2_120_8' class='gform-field-label gform-field-label--type-inline'>Police forces<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_120_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.9' type='checkbox'  value='M\u00e9dias de masse'  id='choice_2_120_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_120_9' id='label_2_120_9' class='gform-field-label gform-field-label--type-inline'>Mass Media<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_120_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.11' type='checkbox'  value='La section commentaires d&#039;un site web'  id='choice_2_120_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_120_11' id='label_2_120_11' class='gform-field-label gform-field-label--type-inline'>Comments section of a website<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_120_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.12' type='checkbox'  value='Les politiques et r\u00e8glements d&#039;une plateforme de m\u00e9dias sociaux'  id='choice_2_120_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_120_12' id='label_2_120_12' class='gform-field-label gform-field-label--type-inline'>Policy or regulation on social networks<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_120_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.13' type='checkbox'  value='Autre(s) (pr\u00e9ciser)'  id='choice_2_120_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_120_13' id='label_2_120_13' class='gform-field-label gform-field-label--type-inline'>Other(s) (Please specify)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_120_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.14' type='checkbox'  value='Je ne sais pas'  id='choice_2_120_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_120_14' id='label_2_120_14' class='gform-field-label gform-field-label--type-inline'>I do not know<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_120_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.15' type='checkbox'  value='Je pr\u00e9f\u00e8re ne pas r\u00e9pondre'  id='choice_2_120_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_120_15' id='label_2_120_15' class='gform-field-label gform-field-label--type-inline'>I prefer not to answer<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_121\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_121'>Other(s)<\/label><div class='ginput_container ginput_container_text'><input name='input_121' id='input_2_121' type='text' value='' class='large' maxlength='350'     aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_2_123' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Back'  \/> <input type='button' id='gform_next_button_2_123' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_2_6' class='gform_page' data-js='page-field-id-123' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_2_6' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_2_124\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">6.  DESCRIPTION <\/h3><\/div><div id=\"field_2_130\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Describe, in your own words, the violence or abuse you&#039;ve witnessed.  <\/h3><\/div><div id=\"field_2_125\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_125'>6T &#8211; Description<\/label><div class='gfield_description' id='gfield_description_2_125'>Please note that there are no restrictions or word limits and that you can upload an audio file in the language you prefer between English, French or Spanish. <\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_125' id='input_2_125' class='textarea large'  aria-describedby=\"gfield_description_2_125\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_2_131\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_2_131'>Audio File<\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_2_131' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_2_131&quot;,&quot;container&quot;:&quot;gform_multifile_upload_2_131&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_2_131&quot;,&quot;filelist&quot;:&quot;gform_preview_2_131&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/alix.interligne.co\\\/en\\\/?gf_page=ed246411945de4e&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/alix.interligne.co\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/alix.interligne.co\\\/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;mp3&quot;}],&quot;max_file_size&quot;:&quot;10485760b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:2,&quot;field_id&quot;:131,&quot;_gform_file_upload_nonce_2_131&quot;:&quot;259d5239bf&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;5&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_2_131&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;phar&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_2_131' 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_2_131' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_2_131\"  >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_2_131'>Accepted file types: mp3, Max. file size: 10 MB, Max. files: 5.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_2_131'><\/ul> <div id='gform_preview_2_131' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_2_126\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">According to you, was this behaviour motivated by hatred or prejudices towards one or several of the victims? <\/h3><\/div><fieldset id=\"field_2_127\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >6T &#8211; Pr\u00e9jug\u00e9 ou haine<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_2_127'>\n\t\t\t<div class='gchoice gchoice_2_127_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_127' type='radio' value='Oui'  id='choice_2_127_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_127_0' id='label_2_127_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_127_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_127' type='radio' value='Non'  id='choice_2_127_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_127_1' id='label_2_127_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_128\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Yes<\/legend><div class='gfield_description' id='gfield_description_2_128'><p>You can select more than one option.<\/p>\r\n<p><\/p>\r\n<p>If the situation has more than one victim, select the answer(s) that applies to each of the victims.<\/p><\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_128'><div class='gchoice gchoice_2_128_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.1' type='checkbox'  value='Identit\u00e9 de genre'  id='choice_2_128_1'   aria-describedby=\"gfield_description_2_128\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_1' id='label_2_128_1' class='gform-field-label gform-field-label--type-inline'>Actual or presumed gender identity<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.2' type='checkbox'  value='Orientation sexuelle'  id='choice_2_128_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_2' id='label_2_128_2' class='gform-field-label gform-field-label--type-inline'>Actual or presumed sexual orientation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.3' type='checkbox'  value='Variation intersexe'  id='choice_2_128_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_3' id='label_2_128_3' class='gform-field-label gform-field-label--type-inline'>Actual or presumed intersex variation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.4' type='checkbox'  value='Parcours trans'  id='choice_2_128_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_4' id='label_2_128_4' class='gform-field-label gform-field-label--type-inline'>Actual or presumed trans journey<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.5' type='checkbox'  value='Parcours d\u00e9trans'  id='choice_2_128_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_5' id='label_2_128_5' class='gform-field-label gform-field-label--type-inline'>Detrans journey<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.6' type='checkbox'  value='Pratiques sexuelles'  id='choice_2_128_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_6' id='label_2_128_6' class='gform-field-label gform-field-label--type-inline'>Sexual practices<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.7' type='checkbox'  value='Appartenance ethnique'  id='choice_2_128_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_7' id='label_2_128_7' class='gform-field-label gform-field-label--type-inline'>Ethnicity<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.8' type='checkbox'  value='Appartenance raciale'  id='choice_2_128_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_8' id='label_2_128_8' class='gform-field-label gform-field-label--type-inline'>Racial affiliation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.9' type='checkbox'  value='Appartenance aux Premi\u00e8res nations, aux peules Inuits et M\u00e9tis'  id='choice_2_128_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_9' id='label_2_128_9' class='gform-field-label gform-field-label--type-inline'>Being part of the First Nations, being Metis or Inuit<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.11' type='checkbox'  value='Appartenance religieuse ou spirituelle'  id='choice_2_128_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_11' id='label_2_128_11' class='gform-field-label gform-field-label--type-inline'>Religious or spiritual affiliation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.12' type='checkbox'  value='Situation d\u2019itin\u00e9rance'  id='choice_2_128_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_12' id='label_2_128_12' class='gform-field-label gform-field-label--type-inline'>Homelessness situation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.13' type='checkbox'  value='Statut d\u2019immigration'  id='choice_2_128_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_13' id='label_2_128_13' class='gform-field-label gform-field-label--type-inline'>Immigration status<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.14' type='checkbox'  value='\u00c9tat civil'  id='choice_2_128_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_14' id='label_2_128_14' class='gform-field-label gform-field-label--type-inline'>Civil or relationship status<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.15' type='checkbox'  value='Statut parental'  id='choice_2_128_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_15' id='label_2_128_15' class='gform-field-label gform-field-label--type-inline'>Being a parent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.16' type='checkbox'  value='Configuration relationnelle'  id='choice_2_128_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_16' id='label_2_128_16' class='gform-field-label gform-field-label--type-inline'>Relational configuration<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_17'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.17' type='checkbox'  value='\u00c9tat de sant\u00e9 mentale'  id='choice_2_128_17'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_17' id='label_2_128_17' class='gform-field-label gform-field-label--type-inline'>Mental health state<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_18'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.18' type='checkbox'  value='Appartenance \u00e0 la neurodivergence'  id='choice_2_128_18'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_18' id='label_2_128_18' class='gform-field-label gform-field-label--type-inline'>Neurotype<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_19'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.19' type='checkbox'  value='Maladie chronique'  id='choice_2_128_19'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_19' id='label_2_128_19' class='gform-field-label gform-field-label--type-inline'>Having a chronic illness<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_21'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.21' type='checkbox'  value='Langue'  id='choice_2_128_21'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_21' id='label_2_128_21' class='gform-field-label gform-field-label--type-inline'>Language<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_22'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.22' type='checkbox'  value='Degr\u00e9 de scolarit\u00e9'  id='choice_2_128_22'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_22' id='label_2_128_22' class='gform-field-label gform-field-label--type-inline'>Level of education<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_23'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.23' type='checkbox'  value='Occupation'  id='choice_2_128_23'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_23' id='label_2_128_23' class='gform-field-label gform-field-label--type-inline'>Occupation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_24'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.24' type='checkbox'  value='Pratique d\u2019une forme de travail du sexe'  id='choice_2_128_24'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_24' id='label_2_128_24' class='gform-field-label gform-field-label--type-inline'>Being or having been a sex worker<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_25'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.25' type='checkbox'  value='Revenu'  id='choice_2_128_25'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_25' id='label_2_128_25' class='gform-field-label gform-field-label--type-inline'>Income<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_26'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.26' type='checkbox'  value='Statut s\u00e9rologique'  id='choice_2_128_26'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_26' id='label_2_128_26' class='gform-field-label gform-field-label--type-inline'>HIV status<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_27'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.27' type='checkbox'  value='Situation de handicap'  id='choice_2_128_27'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_27' id='label_2_128_27' class='gform-field-label gform-field-label--type-inline'>Disability situation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_28'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.28' type='checkbox'  value='Condition de sant\u00e9'  id='choice_2_128_28'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_28' id='label_2_128_28' class='gform-field-label gform-field-label--type-inline'>Health condition<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_29'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.29' type='checkbox'  value='Statut judiciaire'  id='choice_2_128_29'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_29' id='label_2_128_29' class='gform-field-label gform-field-label--type-inline'>Judicial status<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_31'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.31' type='checkbox'  value='\u00c9tat d\u2019intoxication'  id='choice_2_128_31'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_31' id='label_2_128_31' class='gform-field-label gform-field-label--type-inline'>Intoxication level<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_32'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.32' type='checkbox'  value='Expression de genre'  id='choice_2_128_32'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_32' id='label_2_128_32' class='gform-field-label gform-field-label--type-inline'>Gender expression<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_33'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.33' type='checkbox'  value='Couleur de peau'  id='choice_2_128_33'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_33' id='label_2_128_33' class='gform-field-label gform-field-label--type-inline'>Skin color<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_34'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.34' type='checkbox'  value='Apparence physique'  id='choice_2_128_34'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_34' id='label_2_128_34' class='gform-field-label gform-field-label--type-inline'>Physical appearance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_35'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.35' type='checkbox'  value='\u00c2ge'  id='choice_2_128_35'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_35' id='label_2_128_35' class='gform-field-label gform-field-label--type-inline'>Age<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_36'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.36' type='checkbox'  value='Autre(s) (pr\u00e9ciser)'  id='choice_2_128_36'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_36' id='label_2_128_36' class='gform-field-label gform-field-label--type-inline'>Other(s) (Please specify)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_37'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.37' type='checkbox'  value='Je ne sais pas'  id='choice_2_128_37'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_37' id='label_2_128_37' class='gform-field-label gform-field-label--type-inline'>I do not know<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_128_38'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.38' type='checkbox'  value='Je pr\u00e9f\u00e8re ne pas r\u00e9pondre'  id='choice_2_128_38'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_128_38' id='label_2_128_38' class='gform-field-label gform-field-label--type-inline'>I prefer not to answer<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_129\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_129'>Other(s)<\/label><div class='ginput_container ginput_container_text'><input name='input_129' id='input_2_129' type='text' value='' class='large' maxlength='350'     aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_2_132' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Back'  \/> <input type='button' id='gform_next_button_2_132' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_2_7' class='gform_page' data-js='page-field-id-132' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_2_7' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_2_133\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">7. R\u00c9ACTION FACE \u00c0 LA SITUATION<\/h3><\/div><div id=\"field_2_134\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">What was your reaction to this situation?*<\/h3><div class='gsection_description' id='gfield_description_2_134'>You can select more than one option.<\/div><\/div><fieldset id=\"field_2_135\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >7T &#8211; R\u00e9action<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_2_135'><div class='gchoice gchoice_2_135_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_135.1' type='checkbox'  value='Intervenir verbalement'  id='choice_2_135_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_135_1' id='label_2_135_1' class='gform-field-label gform-field-label--type-inline'>Verbal intervention<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_135_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_135.2' type='checkbox'  value='Intervenir physiquement'  id='choice_2_135_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_135_2' id='label_2_135_2' class='gform-field-label gform-field-label--type-inline'>Physical intervention<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_135_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_135.3' type='checkbox'  value='Cr\u00e9er une diversion ou une interruption'  id='choice_2_135_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_135_3' id='label_2_135_3' class='gform-field-label gform-field-label--type-inline'>Create a distraction or an interruption <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_135_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_135.4' type='checkbox'  value='D\u00e9noncer la situation \u00e0 une personne en position d\u2019autorit\u00e9'  id='choice_2_135_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_135_4' id='label_2_135_4' class='gform-field-label gform-field-label--type-inline'>Report the situation to someone in a position of authority <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_135_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_135.5' type='checkbox'  value='Contacter le 911'  id='choice_2_135_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_135_5' id='label_2_135_5' class='gform-field-label gform-field-label--type-inline'>Contact 911 <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_135_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_135.6' type='checkbox'  value='Faire appel \u00e0 une autre personne t\u00e9moin'  id='choice_2_135_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_135_6' id='label_2_135_6' class='gform-field-label gform-field-label--type-inline'>Call on another witness <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_135_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_135.7' type='checkbox'  value='Ne rien faire'  id='choice_2_135_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_135_7' id='label_2_135_7' class='gform-field-label gform-field-label--type-inline'>Do nothing <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_135_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_135.8' type='checkbox'  value='Autres(s)'  id='choice_2_135_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_135_8' id='label_2_135_8' class='gform-field-label gform-field-label--type-inline'>Other(s) (Please specify)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='mm_tooltip_text' style='display:none'><hr \/><p>FR : Nommer \u00e0 la personne violente que son comportement est d\u00e9rangeant ou inacceptable | EN : Name to the person that their action(s) or purpose is inappropriate or violent.<\/p><hr \/><p>FR : S&#8217;interposer physiquement entre la personne violente et la personne victime pour modifier la dynamique de pouvoir | EN : Physically interpose yourself between the violent person and the victim to change the power dynamic<\/p><hr \/><p>FR : Poser une question ou faire un commentaire hors contexte \u00e0 l&#8217;une ou l&#8217;autre des personnes impliqu\u00e9es | EN : Asking a question or making an out-of-context comment to any of the people involved<\/p><\/div><\/fieldset><div id=\"field_2_138\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_138'>Other(s)<\/label><div class='ginput_container ginput_container_text'><input name='input_138' id='input_2_138' type='text' value='' class='large' maxlength='350'     aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_136\" class=\"gfield gfield--type-section gfield--input-type-section gsection alix-color field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">What made you not react to the situation?<\/h3><div class='gsection_description' id='gfield_description_2_136'>You can select more than one option.<\/div><\/div><fieldset id=\"field_2_137\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >7T &#8211; Raison de non action<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_137'><div class='gchoice gchoice_2_137_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_137.1' type='checkbox'  value='Incertitude qu\u2019il s\u2019agissait d\u2019une situation assez grave'  id='choice_2_137_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_137_1' id='label_2_137_1' class='gform-field-label gform-field-label--type-inline'>Uncertain about whether or not the situation was serious enough <\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_137_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_137.2' type='checkbox'  value='Peur des repr\u00e9sailles'  id='choice_2_137_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_137_2' id='label_2_137_2' 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