
{"id":8697,"date":"2019-02-28T10:39:16","date_gmt":"2019-02-28T10:39:16","guid":{"rendered":"http:\/\/arc.local\/?page_id=8697"},"modified":"2020-08-24T15:35:02","modified_gmt":"2020-08-24T19:35:02","slug":"request-assistance-form","status":"publish","type":"page","link":"https:\/\/cwsdemo.thearc.org\/thearc-v3\/request-assistance-form\/","title":{"rendered":"Request for Assistance Form"},"content":{"rendered":"\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-5cr5lf-0f3d6139ba6cb79fb1a85c2d2e5376ec\">\n.avia-section.av-5cr5lf-0f3d6139ba6cb79fb1a85c2d2e5376ec{\nbackground-color:#f2f2f2;\nbackground-image:unset;\n}\n<\/style>\n<div id='av_section_1'  class='avia-section av-5cr5lf-0f3d6139ba6cb79fb1a85c2d2e5376ec main_color avia-section-default avia-no-shadow  avia-builder-el-0  el_before_av_layout_row  avia-builder-el-first  avia-bg-style-scroll container_wrap fullsize'  ><div class='container av-section-cont-open' ><main  role=\"main\" 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.flex_cell.av-15d9h2-f9d150f545dba2527093e8f686a26b09{\npadding:15px 15px 15px 15px !important;\n}\n<\/style>\n<div class='flex_cell av-15d9h2-f9d150f545dba2527093e8f686a26b09 av-gridrow-cell av_one_third no_margin  avia-builder-el-4  el_before_av_cell_one_third  avia-builder-el-first  content-align-middle'  ><div class='flex_cell_inner'>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-9gb812-ae9ebcf48d8851d42c0527510f7323aa\">\n#top .av_textblock_section.av-9gb812-ae9ebcf48d8851d42c0527510f7323aa .avia_textblock{\ncolor:#ffffff;\n}\n<\/style>\n<section  class='av_textblock_section av-9gb812-ae9ebcf48d8851d42c0527510f7323aa '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock av_inherit_color'  itemprop=\"text\" ><p class=\"footer_uper_color_section\" style=\"text-align: center; font-size: 20px; padding: 0px;\"><a href=\"\/join-arc\/\" style=\"text-decoration: none;\">Join the Arc 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itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock av_inherit_color'  itemprop=\"text\" ><p class=\"footer_uper_color_section\" style=\"text-align: center; font-size: 20px; padding: 0px;\"><a href=\"\/memorial_tribute_gifts\/\" style=\"text-decoration: none;\">Donate ><\/a><\/p>\n<\/div><\/section>\n<\/div><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-4qagt2-09b35959eb6191673ec61abea4193437\">\n.flex_cell.av-4qagt2-09b35959eb6191673ec61abea4193437{\nvertical-align:middle;\nbackground-color:#5d2d85;\n}\n.responsive #top #wrap_all .flex_cell.av-4qagt2-09b35959eb6191673ec61abea4193437{\npadding:15px 15px 15px 15px !important;\n}\n<\/style>\n<div class='flex_cell av-4qagt2-09b35959eb6191673ec61abea4193437 av-gridrow-cell av_one_third no_margin  avia-builder-el-8  el_after_av_cell_one_third  avia-builder-el-last  content-align-middle'  ><div class='flex_cell_inner'>\n<style type=\"text\/css\" 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