Resuscitation Council UK Widget

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Enquiry category:

<div class="control-group ticket_section">
                 <label class="  control-label cf_course_type_1107128-label " for="helpdesk_ticket_cf_course_type_1107128">Course type</label>
            <div class="controls   ">
              <select class="  dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_course_type_1107128]" id="helpdesk_ticket_custom_field_cf_course_type_1107128"><option value="">...</option>
<option data-id="3043000843573" value="Anaphylaxis Essential course">Anaphylaxis Essential course</option>
<option data-id="3043000843574" value="Advanced Life Support (ALS) course">Advanced Life Support (ALS) course</option>
<option data-id="3043000843575" value="Advanced Resuscitation of the Newborn Infant (ARNI) course">Advanced Resuscitation of the Newborn Infant (ARNI) course</option>
<option data-id="3043000843576" value="Basic Life Support Instructor (BLSi) course">Basic Life Support Instructor (BLSi) course</option>
<option data-id="3043000843577" value="European Paediatric Advanced Life Support (EPALS) course">European Paediatric Advanced Life Support (EPALS) course</option>
<option data-id="3043000843578" value="Focused Echocardiography in Emergency Life Support (FEEL) course">Focused Echocardiography in Emergency Life Support (FEEL) course</option>
<option data-id="3043000843579" value="Generic Instructor Course (GIC)">Generic Instructor Course (GIC)</option>
<option data-id="3043000843580" value="Immediate Life Support (ILS) course">Immediate Life Support (ILS) course</option>
<option data-id="3043000843581" value="Immediate Life Support Instructor (ILSi) course">Immediate Life Support Instructor (ILSi) course</option>
<option data-id="3043000843582" value="Paediatric Immediate Life Support (PILS) course">Paediatric Immediate Life Support (PILS) course</option>
<option data-id="3043000843583" value="Newborn Life Support (NLS) course">Newborn Life Support (NLS) course</option>
<option data-id="3043000843584" value="e-Lifesaver course">e-Lifesaver course</option></select>
            </div> 
                </div>
      <div class="control-group ticket_section">
                 <label class=" required control-label cf_enquiry_relates_to_1107128-label " for="helpdesk_ticket_cf_enquiry_relates_to_1107128">Enquiry relates to:</label>
            <div class="controls   ">
              <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_enquiry_relates_to_1107128]" id="helpdesk_ticket_custom_field_cf_enquiry_relates_to_1107128"><option value="">...</option>
<option data-id="3043000826663" value="Login issue">Login issue</option>
<option data-id="3043000843585" value="E-learning issue">E-learning issue</option>
<option data-id="3043000843586" value="Clinical support">Clinical support</option>
<option data-id="3043000826656" value="Course certificate">Course certificate</option>
<option data-id="3043000826660" value="Course enrolment">Course enrolment</option>
<option data-id="3043000843587" value="Course evaluation">Course evaluation</option>
<option data-id="3043000843588" value="Course materials">Course materials</option>
<option data-id="3043000843589" value="Course reports">Course reports</option>
<option data-id="3043000843590" value="Instructor query">Instructor query</option>
<option data-id="3043000843591" value="Instructor potential (IP)">Instructor potential (IP)</option>
<option data-id="3043000843592" value="New centre query">New centre query</option>
<option data-id="3043000843593" value="Other">Other</option></select>
            </div> 
                </div>

<div class="control-group ticket_section">
                 <label class="  control-label cf_i_am44286_1107128-label " for="helpdesk_ticket_cf_i_am44286_1107128">I am:</label>
            <div class="controls   ">
              <select class="  dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_i_am44286_1107128]" id="helpdesk_ticket_custom_field_cf_i_am44286_1107128"><option value="">...</option>
<option data-id="3043000799898" value="Member of the public">Member of the public</option>
<option data-id="3043000799899" value="Dentist">Dentist</option>
<option data-id="3043000799900" value="Doctor">Doctor</option>
<option data-id="3043000799901" value="First aid trainer">First aid trainer</option>
<option data-id="3043000799902" value="Nurse">Nurse</option>
<option data-id="3043000799903" value="Paramedic">Paramedic</option>
<option data-id="3043000799904" value="Other clinical">Other clinical</option>
<option data-id="3043000799905" value="Other">Other</option></select>
            </div> 
                </div>
      <div class="control-group ticket_section">
                 <label class=" required control-label cf_enquiry_relates_to358925_1107128-label " for="helpdesk_ticket_cf_enquiry_relates_to358925_1107128">Enquiry relates to:</label>
            <div class="controls   ">
              <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_enquiry_relates_to358925_1107128]" id="helpdesk_ticket_custom_field_cf_enquiry_relates_to358925_1107128"><option value="">...</option>
<option data-id="3043000799906" value="Adult resuscitation">Adult resuscitation</option>
<option data-id="3043000818248" value="Anaphylaxis">Anaphylaxis</option>
<option data-id="3043000818249" value="BLS, AED or Public Access Defibrillator">BLS, AED or Public Access Defibrillator</option>
<option data-id="3043000827562" value="Courses">Courses</option>
<option data-id="3043000818251" value="Decisions relating to CPR">Decisions relating to CPR</option>
<option data-id="3043000799908" value="Newborn resuscitation">Newborn resuscitation</option>
<option data-id="3043000818250" value="Paediatric resuscitation">Paediatric resuscitation</option>
<option data-id="3043000818252" value="Quality Standards and Practices">Quality Standards and Practices</option>
<option data-id="3043000818253" value="Resuscitation Guidelines">Resuscitation Guidelines</option>
<option data-id="3043000843599" value="ReSPECT">ReSPECT</option>
<option data-id="3043000799909" value="Other">Other</option></select>
            </div> 
                </div>

<div class="control-group ticket_section">
                 <label class="  control-label cf_relates_to_1107128-label " for="helpdesk_ticket_cf_relates_to_1107128">Relates to:</label>
            <div class="controls   ">
              <select class="  dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_relates_to_1107128]" id="helpdesk_ticket_custom_field_cf_relates_to_1107128"><option value="">...</option>
<option data-id="3043000843595" value="RCUK Associate Membership">RCUK Associate Membership</option>
<option data-id="3043000847796" value="RCUK Full Membershp">RCUK Full Membershp</option>
<option data-id="3043000847797" value="RCUK Honorary Membership">RCUK Honorary Membership</option>
<option data-id="3043000847798" value="Other">Other</option></select>
            </div> 
                </div>
      <div class="control-group ticket_section">
                 <label class=" required control-label cf_enquiry_relates_to66132_1107128-label " for="helpdesk_ticket_cf_enquiry_relates_to66132_1107128">Enquiry relates to:</label>
            <div class="controls   ">
              <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_enquiry_relates_to66132_1107128]" id="helpdesk_ticket_custom_field_cf_enquiry_relates_to66132_1107128"><option value="">...</option>
<option data-id="3043000843594" value="Become a member">Become a member</option>
<option data-id="3043000826673" value="Change my membership type">Change my membership type</option>
<option data-id="3043000826674" value="Renew my membership">Renew my membership</option>
<option data-id="3043000826675" value="Cancel my membership">Cancel my membership</option>
<option data-id="3043000826676" value="Other">Other</option></select>
            </div> 
                </div>

<div class="control-group ticket_section">
                 <label class=" required control-label cf_enquiry_relates_to909330_1107128-label " for="helpdesk_ticket_cf_enquiry_relates_to909330_1107128">Enquiry relates to:</label>
            <div class="controls   ">
              <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_enquiry_relates_to909330_1107128]" id="helpdesk_ticket_custom_field_cf_enquiry_relates_to909330_1107128"><option value="">...</option>
<option data-id="3043000826677" value="Certification verification">Certification verification</option>
<option data-id="3043000826678" value="Research & Development Grant">Research & Development Grant</option>
<option data-id="3043000826679" value="Website issue">Website issue</option>
<option data-id="3043000840872" value="ResusReady">ResusReady</option>
<option data-id="3043000826680" value="Other">Other</option></select>
            </div> 
                </div>

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