/*jslint nomen:false, debug:true, evil:true, vars:false, browser:true, forin:true, undef:false, white:false */ /** * Includes a Form with javascript * @param {Object} formId * @param {Object} initialHeight * @param {Object} iframeCode */ function FrameBuilder (formId, appendTo, initialHeight, iframeCode){ this.formId = formId; this.initialHeight = initialHeight; this.iframeCode = iframeCode; this.frame = null; this.timeInterval= 200; this.appendTo = appendTo || false; // initialize function for object this.init = function(){ this.createFrame(); this.addFrameContent(this.iframeCode); }; // Create the frame this.createFrame = function(){ var htmlCode = "<"+"iframe src=\"\" allowtransparency=\"true\" frameborder=\"0\" name=\""+this.formId+"\" id=\""+this.formId+"\" style=\"width:100%; height:"+this.initialHeight+"px; border:none;\" scrolling=\"no\">"; if(this.appendTo === false){ document.write(htmlCode); }else{ var tmp = document.createElement('div'); tmp.innerHTML = htmlCode; var a = this.appendTo; document.getElementById(a).appendChild(tmp.firstChild); } // also get the frame for future use. this.frame = document.getElementById(this.formId); // set the time on the on load event of the frame this.addEvent(this.frame, 'load', this.bindMethod(this.setTimer, this)); }; // add event function for different browsers this.addEvent = function( obj, type, fn ) { if ( obj.attachEvent ) { obj["e"+type+fn] = fn; obj[type+fn] = function() { obj["e"+type+fn]( window.event ); }; obj.attachEvent( "on"+type, obj[type+fn] ); } else{ obj.addEventListener( type, fn, false ); } }; this.addFrameContent = function (string){ string = string.replace(new RegExp('src\\=\\"[^"]*captcha.php\"><\/scr'+'ipt>', 'gim'), 'src="http://api.recaptcha.net/js/recaptcha_ajax.js"><'+'div id="recaptcha_div"><'+'/div>'+ '<'+'style>#recaptcha_logo{ display:none;} #recaptcha_tagline{display:none;} #recaptcha_table{border:none !important;} .recaptchatable .recaptcha_image_cell, #recaptcha_table{ background-color:transparent !important; } <'+'/style>'+ '<'+'script defer="defer"> window.onload = function(){ Recaptcha.create("6Ld9UAgAAAAAAMon8zjt30tEZiGQZ4IIuWXLt1ky", "recaptcha_div", {theme: "clean",tabindex: 0,callback: function (){'+ 'if (document.getElementById("uword")) { document.getElementById("uword").parentNode.removeChild(document.getElementById("uword")); } if (window["validate"] !== undefined) { if (document.getElementById("recaptcha_response_field")){ document.getElementById("recaptcha_response_field").onblur = function(){ validate(document.getElementById("recaptcha_response_field"), "Required"); } } } if (document.getElementById("recaptcha_response_field")){ document.getElementsByName("recaptcha_challenge_field")[0].setAttribute("name", "anum"); } if (document.getElementById("recaptcha_response_field")){ document.getElementsByName("recaptcha_response_field")[0].setAttribute("name", "qCap"); }}})'+ ' }<'+'/script>'); string = string.replace(/(type="text\/javascript">)\s+(validate\(\"[^"]*"\);)/, '$1 jTime = setInterval(function(){if("validate" in window){$2clearTimeout(jTime);}}, 1000);'); var frameDocument = (this.frame.contentWindow) ? this.frame.contentWindow : (this.frame.contentDocument.document) ? this.frame.contentDocument.document : this.frame.contentDocument; frameDocument.document.open(); frameDocument.document.write(string); setTimeout( function(){ frameDocument.document.close(); try{ if('JotFormFrameLoaded' in window){ JotFormFrameLoaded(); } }catch(e){} },200); }; this.setTimer = function(){ var self = this; this.interval = setTimeout(function(){self.changeHeight();},this.timeInterval); }; this.changeHeight = function (){ var actualHeight = this.getBodyHeight(); var currentHeight = this.getViewPortHeight(); if(actualHeight === undefined){ this.frame.style.height = "100%"; if(!this.frame.style.minHeight){ this.frame.style.minHeight = "300px"; } }else if (Math.abs(actualHeight - currentHeight) > 18){ this.frame.style.height = (actualHeight)+"px"; } this.setTimer(); }; this.bindMethod = function(method, scope) { return function() { method.apply(scope,arguments); }; }; this.getBodyHeight = function (){ var height; var scrollHeight; var offsetHeight; try{ // Prevent IE from throw errors if (this.frame.contentWindow.document.height){ height = this.frame.contentWindow.document.height; //Emre: to prevent "iframe height" problem (61059) if (this.frame.contentWindow.document.body.scrollHeight){ height = scrollHeight = this.frame.contentWindow.document.body.scrollHeight; } if (this.frame.contentWindow.document.body.offsetHeight){ height = offsetHeight = this.frame.contentWindow.document.body.offsetHeight; } } else if (this.frame.contentWindow.document.body){ if (this.frame.contentWindow.document.body.scrollHeight){ height = scrollHeight = this.frame.contentWindow.document.body.scrollHeight; } if (this.frame.contentWindow.document.body.offsetHeight){ height = offsetHeight = this.frame.contentWindow.document.body.offsetHeight; } if (scrollHeight && offsetHeight){ height = Math.max(scrollHeight, offsetHeight); } } }catch(e){ } return height; }; this.getViewPortHeight = function(){ var height = 0; try{ // Prevent IE from throw errors if (this.frame.contentWindow.window.innerHeight) { height = this.frame.contentWindow.window.innerHeight - 18; } else if ((this.frame.contentWindow.document.documentElement) && (this.frame.contentWindow.document.documentElement.clientHeight)) { height = this.frame.contentWindow.document.documentElement.clientHeight; } else if ((this.frame.contentWindow.document.body) && (this.frame.contentWindow.document.body.clientHeight)) { height = this.frame.contentWindow.document.body.clientHeight; } }catch(e){ } return height; }; this.init(); } FrameBuilder.get = []; var i2002202210 = new FrameBuilder("2002202210", false, "", "\n\n\n\n\nForm<\/title>\n<link href=\"http:\/\/max.jotfor.ms\/min\/g=formCss?3.0.2435\" rel=\"stylesheet\" type=\"text\/css\" \/>\n<style type=\"text\/css\">\n .form-label{\n width:150px !important;\n }\n .form-label-left{\n width:150px !important;\n }\n .form-line{\n padding:5px;\n }\n .form-label-right{\n width:150px !important;\n }\n body, html{\n margin:0;\n padding:0;\n background:white;\n }\n\n .form-all{\n margin:0px auto;\n padding-top:20px;\n width:500px;\n background:white;\n color:black !important;\n font-family:Verdana;\n font-size:12px;\n }\n<\/style>\n\n<script src=\"http:\/\/max.jotfor.ms\/min\/g=jotform?3.0.2435\" type=\"text\/javascript\"><\/script>\n<script type=\"text\/javascript\">\n var jsTime = setInterval(function(){try{\n JotForm.jsForm = true;\n\n JotForm.init(function(){\n $('input_89').hint('ex: myname@example.com');\n JotForm.description('input_49', 'Did you have JA when you were a student?');\n JotForm.description('input_77', '20');\n });\n\n clearInterval(jsTime);\n }catch(e){}}, 1000);\n<\/script>\n<\/head>\n<body>\n<form class=\"jotform-form\" action=\"http:\/\/submit.jotform.com\/submit.php\" method=\"post\" name=\"form_2002202210\" id=\"2002202210\" accept-charset=\"utf-8\">\n <input type=\"hidden\" name=\"formID\" value=\"2002202210\" \/>\n <div class=\"form-all\">\n <ul class=\"form-section\">\n <li class=\"form-line\" id=\"id_98\">\n <div id=\"cid_98\" class=\"form-input-wide\">\n <div style=\"text-align:center;\">\n <img alt=\"\" class=\"form-image\" border=\"0\" src=\"http:\/\/www.jotform.com\/uploads\/twiga007\/form_files\/Green_and_gold_centered.jpg\" height=\"177.6\" width=\"480\" \/>\n <\/div>\n <\/div>\n <\/li>\n <li id=\"cid_99\" class=\"form-input-wide\">\n <div class=\"form-header-group\">\n <h2 id=\"header_99\" class=\"form-header\">\n Thank you for your interest in volunteering with Junior Achievement.\n <\/h2>\n <\/div>\n <\/li>\n <li id=\"cid_43\" class=\"form-input-wide\">\n <div class=\"form-header-group\">\n <h2 id=\"header_43\" class=\"form-header\">\n Personal Information\n <\/h2>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_41\">\n <label class=\"form-label-left\" id=\"label_41\" for=\"input_41\">\n Preferred County:<span class=\"form-required\">*<\/span>\n <\/label>\n <div id=\"cid_41\" class=\"form-input\">\n <select class=\"form-dropdown validate[required]\" style=\"width:150px\" id=\"input_41\" name=\"q41_preferredCounty\">\n <option> <\/option>\n <option value=\"Highlands\"> Highlands <\/option>\n <option value=\"Polk\"> Polk <\/option>\n <\/select>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_83\">\n <label class=\"form-label-left\" id=\"label_83\" for=\"input_83\">\n Full Name:<span class=\"form-required\">*<\/span>\n <\/label>\n <div id=\"cid_83\" class=\"form-input\"><span class=\"form-sub-label-container\"><input class=\"form-textbox\" type=\"text\" name=\"q83_fullName[prefix]\" size=\"4\" id=\"pre_83\" \/>\n <label class=\"form-sub-label\" for=\"pre_83\" id=\"sublabel_prefix\"> Prefix <\/label><\/span><span class=\"form-sub-label-container\"><input class=\"form-textbox validate[required]\" type=\"text\" size=\"10\" name=\"q83_fullName[first]\" id=\"first_83\" \/>\n <label class=\"form-sub-label\" for=\"first_83\" id=\"sublabel_first\"> First Name <\/label><\/span><span class=\"form-sub-label-container\"><input class=\"form-textbox validate[required]\" type=\"text\" size=\"15\" name=\"q83_fullName[last]\" id=\"last_83\" \/>\n <label class=\"form-sub-label\" for=\"last_83\" id=\"sublabel_last\"> Last Name <\/label><\/span>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_84\">\n <label class=\"form-label-left\" id=\"label_84\" for=\"input_84\">\n Address:<span class=\"form-required\">*<\/span>\n <\/label>\n <div id=\"cid_84\" class=\"form-input\">\n <table summary=\"\" class=\"form-address-table\" border=\"0\" cellpadding=\"0\" cellspacing=\"0\">\n <tr>\n <td colspan=\"2\"><span class=\"form-sub-label-container\"><input class=\"form-textbox validate[required] form-address-line\" type=\"text\" name=\"q84_address84[addr_line1]\" id=\"input_84_addr_line1\" \/>\n <label class=\"form-sub-label\" for=\"input_84_addr_line1\" id=\"sublabel_addr_line1\"> Street Address <\/label><\/span>\n <\/td>\n <\/tr>\n <tr>\n <td colspan=\"2\"><span class=\"form-sub-label-container\"><input class=\"form-textbox form-address-line\" type=\"text\" name=\"q84_address84[addr_line2]\" id=\"input_84_addr_line2\" size=\"46\" \/>\n <label class=\"form-sub-label\" for=\"input_84_addr_line2\" id=\"sublabel_addr_line2\"> Street Address Line 2 <\/label><\/span>\n <\/td>\n <\/tr>\n <tr>\n <td width=\"50%\"><span class=\"form-sub-label-container\"><input class=\"form-textbox validate[required] form-address-city\" type=\"text\" name=\"q84_address84[city]\" id=\"input_84_city\" size=\"21\" \/>\n <label class=\"form-sub-label\" for=\"input_84_city\" id=\"sublabel_city\"> City <\/label><\/span>\n <\/td>\n <td><span class=\"form-sub-label-container\"><input class=\"form-textbox validate[required] form-address-state\" type=\"text\" name=\"q84_address84[state]\" id=\"input_84_state\" size=\"22\" \/>\n <label class=\"form-sub-label\" for=\"input_84_state\" id=\"sublabel_state\"> State \/ Province <\/label><\/span>\n <\/td>\n <\/tr>\n <tr>\n <td width=\"50%\"><span class=\"form-sub-label-container\"><input class=\"form-textbox validate[required] form-address-postal\" type=\"text\" name=\"q84_address84[postal]\" id=\"input_84_postal\" size=\"10\" \/>\n <label class=\"form-sub-label\" for=\"input_84_postal\" id=\"sublabel_postal\"> Postal \/ Zip Code <\/label><\/span>\n <\/td>\n <td><span class=\"form-sub-label-container\"><select class=\"form-dropdown validate[required] form-address-country\" name=\"q84_address84[country]\" id=\"input_84_country\">\n <option selected> Please Select <\/option>\n <option value=\"United States\"> United States <\/option>\n <option value=\"Abkhazia\"> Abkhazia <\/option>\n <option value=\"Afghanistan\"> Afghanistan <\/option>\n <option value=\"Albania\"> Albania <\/option>\n <option value=\"Algeria\"> Algeria <\/option>\n <option value=\"American Samoa\"> American Samoa <\/option>\n <option value=\"Andorra\"> Andorra <\/option>\n <option value=\"Angola\"> Angola <\/option>\n <option value=\"Anguilla\"> Anguilla <\/option>\n <option value=\"Antigua and Barbuda\"> Antigua and Barbuda <\/option>\n <option value=\"Argentina\"> Argentina <\/option>\n <option value=\"Armenia\"> Armenia <\/option>\n <option value=\"Aruba\"> Aruba <\/option>\n <option value=\"Australia\"> Australia <\/option>\n <option value=\"Austria\"> Austria <\/option>\n <option value=\"Azerbaijan\"> Azerbaijan <\/option>\n <option value=\"The Bahamas\"> The Bahamas <\/option>\n <option value=\"Bahrain\"> Bahrain <\/option>\n <option value=\"Bangladesh\"> Bangladesh <\/option>\n <option value=\"Barbados\"> Barbados <\/option>\n <option value=\"Belarus\"> Belarus <\/option>\n <option value=\"Belgium\"> Belgium <\/option>\n <option value=\"Belize\"> Belize <\/option>\n <option value=\"Benin\"> Benin <\/option>\n <option value=\"Bermuda\"> Bermuda <\/option>\n <option value=\"Bhutan\"> Bhutan <\/option>\n <option value=\"Bolivia\"> Bolivia <\/option>\n <option value=\"Bosnia and Herzegovina\"> Bosnia and Herzegovina <\/option>\n <option value=\"Botswana\"> Botswana <\/option>\n <option value=\"Brazil\"> Brazil <\/option>\n <option value=\"Brunei\"> Brunei <\/option>\n <option value=\"Bulgaria\"> Bulgaria <\/option>\n <option value=\"Burkina Faso\"> Burkina Faso <\/option>\n <option value=\"Burundi\"> Burundi <\/option>\n <option value=\"Cambodia\"> Cambodia <\/option>\n <option value=\"Cameroon\"> Cameroon <\/option>\n <option value=\"Canada\"> Canada <\/option>\n <option value=\"Cape Verde\"> Cape Verde <\/option>\n <option value=\"Cayman Islands\"> Cayman Islands <\/option>\n <option value=\"Central African Republic\"> Central African Republic <\/option>\n <option value=\"Chad\"> Chad <\/option>\n <option value=\"Chile\"> Chile <\/option>\n <option value=\"People's Republic of China\"> People's Republic of China <\/option>\n <option value=\"Republic of China\"> Republic of China <\/option>\n <option value=\"Christmas Island\"> Christmas Island <\/option>\n <option value=\"Cocos (Keeling) Islands\"> Cocos (Keeling) Islands <\/option>\n <option value=\"Colombia\"> Colombia <\/option>\n <option value=\"Comoros\"> Comoros <\/option>\n <option value=\"Congo\"> Congo <\/option>\n <option value=\"Cook Islands\"> Cook Islands <\/option>\n <option value=\"Costa Rica\"> Costa Rica <\/option>\n <option value=\"Cote d'Ivoire\"> Cote d'Ivoire <\/option>\n <option value=\"Croatia\"> Croatia <\/option>\n <option value=\"Cuba\"> Cuba <\/option>\n <option value=\"Cyprus\"> Cyprus <\/option>\n <option value=\"Czech Republic\"> Czech Republic <\/option>\n <option value=\"Denmark\"> Denmark <\/option>\n <option value=\"Djibouti\"> Djibouti <\/option>\n <option value=\"Dominica\"> Dominica <\/option>\n <option value=\"Dominican Republic\"> Dominican Republic <\/option>\n <option value=\"Ecuador\"> Ecuador <\/option>\n <option value=\"Egypt\"> Egypt <\/option>\n <option value=\"El Salvador\"> El Salvador <\/option>\n <option value=\"Equatorial Guinea\"> Equatorial Guinea <\/option>\n <option value=\"Eritrea\"> Eritrea <\/option>\n <option value=\"Estonia\"> Estonia <\/option>\n <option value=\"Ethiopia\"> Ethiopia <\/option>\n <option value=\"Falkland Islands\"> Falkland Islands <\/option>\n <option value=\"Faroe Islands\"> Faroe Islands <\/option>\n <option value=\"Fiji\"> Fiji <\/option>\n <option value=\"Finland\"> Finland <\/option>\n <option value=\"France\"> France <\/option>\n <option value=\"French Polynesia\"> French Polynesia <\/option>\n <option value=\"Gabon\"> Gabon <\/option>\n <option value=\"The Gambia\"> The Gambia <\/option>\n <option value=\"Georgia\"> Georgia <\/option>\n <option value=\"Germany\"> Germany <\/option>\n <option value=\"Ghana\"> Ghana <\/option>\n <option value=\"Gibraltar\"> Gibraltar <\/option>\n <option value=\"Greece\"> Greece <\/option>\n <option value=\"Greenland\"> Greenland <\/option>\n <option value=\"Grenada\"> Grenada <\/option>\n <option value=\"Guadeloupe\"> Guadeloupe <\/option>\n <option value=\"Guam\"> Guam <\/option>\n <option value=\"Guatemala\"> Guatemala <\/option>\n <option value=\"Guernsey\"> Guernsey <\/option>\n <option value=\"Guinea\"> Guinea <\/option>\n <option value=\"Guinea-Bissau\"> Guinea-Bissau <\/option>\n <option value=\"Guyana\"> Guyana <\/option>\n <option value=\"Haiti\"> Haiti <\/option>\n <option value=\"Honduras\"> Honduras <\/option>\n <option value=\"Hong Kong\"> Hong Kong <\/option>\n <option value=\"Hungary\"> Hungary <\/option>\n <option value=\"Iceland\"> Iceland <\/option>\n <option value=\"India\"> India <\/option>\n <option value=\"Indonesia\"> Indonesia <\/option>\n <option value=\"Iran\"> Iran <\/option>\n <option value=\"Iraq\"> Iraq <\/option>\n <option value=\"Ireland\"> Ireland <\/option>\n <option value=\"Israel\"> Israel <\/option>\n <option value=\"Italy\"> Italy <\/option>\n <option value=\"Jamaica\"> Jamaica <\/option>\n <option value=\"Japan\"> Japan <\/option>\n <option value=\"Jersey\"> Jersey <\/option>\n <option value=\"Jordan\"> Jordan <\/option>\n <option value=\"Kazakhstan\"> Kazakhstan <\/option>\n <option value=\"Kenya\"> Kenya <\/option>\n <option value=\"Kiribati\"> Kiribati <\/option>\n <option value=\"North Korea\"> North Korea <\/option>\n <option value=\"South Korea\"> South Korea <\/option>\n <option value=\"Kosovo\"> Kosovo <\/option>\n <option value=\"Kuwait\"> Kuwait <\/option>\n <option value=\"Kyrgyzstan\"> Kyrgyzstan <\/option>\n <option value=\"Laos\"> Laos <\/option>\n <option value=\"Latvia\"> Latvia <\/option>\n <option value=\"Lebanon\"> Lebanon <\/option>\n <option value=\"Lesotho\"> Lesotho <\/option>\n <option value=\"Liberia\"> Liberia <\/option>\n <option value=\"Libya\"> Libya <\/option>\n <option value=\"Liechtenstein\"> Liechtenstein <\/option>\n <option value=\"Lithuania\"> Lithuania <\/option>\n <option value=\"Luxembourg\"> Luxembourg <\/option>\n <option value=\"Macau\"> Macau <\/option>\n <option value=\"Macedonia\"> Macedonia <\/option>\n <option value=\"Madagascar\"> Madagascar <\/option>\n <option value=\"Malawi\"> Malawi <\/option>\n <option value=\"Malaysia\"> Malaysia <\/option>\n <option value=\"Maldives\"> Maldives <\/option>\n <option value=\"Mali\"> Mali <\/option>\n <option value=\"Malta\"> Malta <\/option>\n <option value=\"Marshall Islands\"> Marshall Islands <\/option>\n <option value=\"Martinique\"> Martinique <\/option>\n <option value=\"Mauritania\"> Mauritania <\/option>\n <option value=\"Mauritius\"> Mauritius <\/option>\n <option value=\"Mayotte\"> Mayotte <\/option>\n <option value=\"Mexico\"> Mexico <\/option>\n <option value=\"Micronesia\"> Micronesia <\/option>\n <option value=\"Moldova\"> Moldova <\/option>\n <option value=\"Monaco\"> Monaco <\/option>\n <option value=\"Mongolia\"> Mongolia <\/option>\n <option value=\"Montenegro\"> Montenegro <\/option>\n <option value=\"Montserrat\"> Montserrat <\/option>\n <option value=\"Morocco\"> Morocco <\/option>\n <option value=\"Mozambique\"> Mozambique <\/option>\n <option value=\"Myanmar\"> Myanmar <\/option>\n <option value=\"Nagorno-Karabakh\"> Nagorno-Karabakh <\/option>\n <option value=\"Namibia\"> Namibia <\/option>\n <option value=\"Nauru\"> Nauru <\/option>\n <option value=\"Nepal\"> Nepal <\/option>\n <option value=\"Netherlands\"> Netherlands <\/option>\n <option value=\"Netherlands Antilles\"> Netherlands Antilles <\/option>\n <option value=\"New Caledonia\"> New Caledonia <\/option>\n <option value=\"New Zealand\"> New Zealand <\/option>\n <option value=\"Nicaragua\"> Nicaragua <\/option>\n <option value=\"Niger\"> Niger <\/option>\n <option value=\"Nigeria\"> Nigeria <\/option>\n <option value=\"Niue\"> Niue <\/option>\n <option value=\"Norfolk Island\"> Norfolk Island <\/option>\n <option value=\"Turkish Republic of Northern Cyprus\"> Turkish Republic of Northern Cyprus <\/option>\n <option value=\"Northern Mariana\"> Northern Mariana <\/option>\n <option value=\"Norway\"> Norway <\/option>\n <option value=\"Oman\"> Oman <\/option>\n <option value=\"Pakistan\"> Pakistan <\/option>\n <option value=\"Palau\"> Palau <\/option>\n <option value=\"Palestine\"> Palestine <\/option>\n <option value=\"Panama\"> Panama <\/option>\n <option value=\"Papua New Guinea\"> Papua New Guinea <\/option>\n <option value=\"Paraguay\"> Paraguay <\/option>\n <option value=\"Peru\"> Peru <\/option>\n <option value=\"Philippines\"> Philippines <\/option>\n <option value=\"Pitcairn Islands\"> Pitcairn Islands <\/option>\n <option value=\"Poland\"> Poland <\/option>\n <option value=\"Portugal\"> Portugal <\/option>\n <option value=\"Puerto Rico\"> Puerto Rico <\/option>\n <option value=\"Qatar\"> Qatar <\/option>\n <option value=\"Romania\"> Romania <\/option>\n <option value=\"Russia\"> Russia <\/option>\n <option value=\"Rwanda\"> Rwanda <\/option>\n <option value=\"Saint Barthelemy\"> Saint Barthelemy <\/option>\n <option value=\"Saint Helena\"> Saint Helena <\/option>\n <option value=\"Saint Kitts and Nevis\"> Saint Kitts and Nevis <\/option>\n <option value=\"Saint Lucia\"> Saint Lucia <\/option>\n <option value=\"Saint Martin\"> Saint Martin <\/option>\n <option value=\"Saint Pierre and Miquelon\"> Saint Pierre and Miquelon <\/option>\n <option value=\"Saint Vincent and the Grenadines\"> Saint Vincent and the Grenadines <\/option>\n <option value=\"Samoa\"> Samoa <\/option>\n <option value=\"San Marino\"> San Marino <\/option>\n <option value=\"Sao Tome and Principe\"> Sao Tome and Principe <\/option>\n <option value=\"Saudi Arabia\"> Saudi Arabia <\/option>\n <option value=\"Senegal\"> Senegal <\/option>\n <option value=\"Serbia\"> Serbia <\/option>\n <option value=\"Seychelles\"> Seychelles <\/option>\n <option value=\"Sierra Leone\"> Sierra Leone <\/option>\n <option value=\"Singapore\"> Singapore <\/option>\n <option value=\"Slovakia\"> Slovakia <\/option>\n <option value=\"Slovenia\"> Slovenia <\/option>\n <option value=\"Solomon Islands\"> Solomon Islands <\/option>\n <option value=\"Somalia\"> Somalia <\/option>\n <option value=\"Somaliland\"> Somaliland <\/option>\n <option value=\"South Africa\"> South Africa <\/option>\n <option value=\"South Ossetia\"> South Ossetia <\/option>\n <option value=\"Spain\"> Spain <\/option>\n <option value=\"Sri Lanka\"> Sri Lanka <\/option>\n <option value=\"Sudan\"> Sudan <\/option>\n <option value=\"Suriname\"> Suriname <\/option>\n <option value=\"Svalbard\"> Svalbard <\/option>\n <option value=\"Swaziland\"> Swaziland <\/option>\n <option value=\"Sweden\"> Sweden <\/option>\n <option value=\"Switzerland\"> Switzerland <\/option>\n <option value=\"Syria\"> Syria <\/option>\n <option value=\"Taiwan\"> Taiwan <\/option>\n <option value=\"Tajikistan\"> Tajikistan <\/option>\n <option value=\"Tanzania\"> Tanzania <\/option>\n <option value=\"Thailand\"> Thailand <\/option>\n <option value=\"Timor-Leste\"> Timor-Leste <\/option>\n <option value=\"Togo\"> Togo <\/option>\n <option value=\"Tokelau\"> Tokelau <\/option>\n <option value=\"Tonga\"> Tonga <\/option>\n <option value=\"Transnistria Pridnestrovie\"> Transnistria Pridnestrovie <\/option>\n <option value=\"Trinidad and Tobago\"> Trinidad and Tobago <\/option>\n <option value=\"Tristan da Cunha\"> Tristan da Cunha <\/option>\n <option value=\"Tunisia\"> Tunisia <\/option>\n <option value=\"Turkey\"> Turkey <\/option>\n <option value=\"Turkmenistan\"> Turkmenistan <\/option>\n <option value=\"Turks and Caicos Islands\"> Turks and Caicos Islands <\/option>\n <option value=\"Tuvalu\"> Tuvalu <\/option>\n <option value=\"Uganda\"> Uganda <\/option>\n <option value=\"Ukraine\"> Ukraine <\/option>\n <option value=\"United Arab Emirates\"> United Arab Emirates <\/option>\n <option value=\"United Kingdom\"> United Kingdom <\/option>\n <option value=\"Uruguay\"> Uruguay <\/option>\n <option value=\"Uzbekistan\"> Uzbekistan <\/option>\n <option value=\"Vanuatu\"> Vanuatu <\/option>\n <option value=\"Vatican City\"> Vatican City <\/option>\n <option value=\"Venezuela\"> Venezuela <\/option>\n <option value=\"Vietnam\"> Vietnam <\/option>\n <option value=\"British Virgin Islands\"> British Virgin Islands <\/option>\n <option value=\"US Virgin Islands\"> US Virgin Islands <\/option>\n <option value=\"Wallis and Futuna\"> Wallis and Futuna <\/option>\n <option value=\"Western Sahara\"> Western Sahara <\/option>\n <option value=\"Yemen\"> Yemen <\/option>\n <option value=\"Zambia\"> Zambia <\/option>\n <option value=\"Zimbabwe\"> Zimbabwe <\/option>\n <option value=\"other\"> Other <\/option>\n <\/select>\n <label class=\"form-sub-label\" for=\"input_84_country\" id=\"sublabel_country\"> Country <\/label><\/span>\n <\/td>\n <\/tr>\n <\/table>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_87\">\n <label class=\"form-label-left\" id=\"label_87\" for=\"input_87\">\n Contact Number Type:<span class=\"form-required\">*<\/span>\n <\/label>\n <div id=\"cid_87\" class=\"form-input\">\n <select class=\"form-dropdown validate[required]\" style=\"width:150px\" id=\"input_87\" name=\"q87_contactNumber87\">\n <option> <\/option>\n <option value=\"Home Phone \"> Home Phone <\/option>\n <option value=\"Cell Phone\"> Cell Phone <\/option>\n <\/select>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_85\">\n <label class=\"form-label-left\" id=\"label_85\" for=\"input_85\">\n Contact Number:<span class=\"form-required\">*<\/span>\n <\/label>\n <div id=\"cid_85\" class=\"form-input\"><span class=\"form-sub-label-container\"><input class=\"form-textbox validate[required]\" type=\"tel\" name=\"q85_contactNumber[area]\" id=\"input_85_area\" size=\"3\">\n -\n <label class=\"form-sub-label\" for=\"input_85_area\" id=\"sublabel_area\"> Area Code <\/label><\/span><span class=\"form-sub-label-container\"><input class=\"form-textbox validate[required]\" type=\"tel\" name=\"q85_contactNumber[phone]\" id=\"input_85_phone\" size=\"8\">\n <label class=\"form-sub-label\" for=\"input_85_phone\" id=\"sublabel_phone\"> Phone Number <\/label><\/span>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_88\">\n <label class=\"form-label-left\" id=\"label_88\" for=\"input_88\"> Alternate Number Type: <\/label>\n <div id=\"cid_88\" class=\"form-input\">\n <select class=\"form-dropdown\" style=\"width:150px\" id=\"input_88\" name=\"q88_alternateNumber88\">\n <option> <\/option>\n <option value=\"Home Phone\"> Home Phone <\/option>\n <option value=\"Cell Phone\"> Cell Phone <\/option>\n <\/select>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_86\">\n <label class=\"form-label-left\" id=\"label_86\" for=\"input_86\"> Alternate Number: <\/label>\n <div id=\"cid_86\" class=\"form-input\"><span class=\"form-sub-label-container\"><input class=\"form-textbox\" type=\"tel\" name=\"q86_alternateNumber86[area]\" id=\"input_86_area\" size=\"3\">\n -\n <label class=\"form-sub-label\" for=\"input_86_area\" id=\"sublabel_area\"> Area Code <\/label><\/span><span class=\"form-sub-label-container\"><input class=\"form-textbox\" type=\"tel\" name=\"q86_alternateNumber86[phone]\" id=\"input_86_phone\" size=\"8\">\n <label class=\"form-sub-label\" for=\"input_86_phone\" id=\"sublabel_phone\"> Phone Number <\/label><\/span>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_89\">\n <label class=\"form-label-left\" id=\"label_89\" for=\"input_89\">\n E-mail:<span class=\"form-required\">*<\/span>\n <\/label>\n <div id=\"cid_89\" class=\"form-input\">\n <input type=\"email\" class=\"form-textbox validate[required, Email]\" id=\"input_89\" name=\"q89_email89\" size=\"30\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_17\">\n <label class=\"form-label-left\" id=\"label_17\" for=\"input_17\"> I am available to teach: <\/label>\n <div id=\"cid_17\" class=\"form-input\">\n <div class=\"form-single-column\"><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox\" id=\"input_17_0\" name=\"q17_iAm17[]\" value=\"Fall - (Sept-Dec)\" \/>\n <label for=\"input_17_0\"> Fall - (Sept-Dec) <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox\" id=\"input_17_1\" name=\"q17_iAm17[]\" value=\"Winter - (Jan-Mar)\" \/>\n <label for=\"input_17_1\"> Winter - (Jan-Mar) <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox\" id=\"input_17_2\" name=\"q17_iAm17[]\" value=\"Spring - (April-June)\" \/>\n <label for=\"input_17_2\"> Spring - (April-June) <\/label><\/span><span class=\"clearfix\"><\/span>\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_16\">\n <label class=\"form-label-left\" id=\"label_16\" for=\"input_16\"> Preferred School\/Program: <\/label>\n <div id=\"cid_16\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_16\" name=\"q16_preferredSchoolprogram16\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li id=\"cid_45\" class=\"form-input-wide\">\n <div class=\"form-pagebreak\">\n <div class=\"form-pagebreak-back-container form-label-left\">\n <button type=\"button\" class=\"form-pagebreak-back\" id=\"form-pagebreak-back_45\">\n Back\n <\/button>\n <\/div>\n <div class=\"form-pagebreak-next-container\">\n <button type=\"button\" class=\"form-pagebreak-next\" id=\"form-pagebreak-next_45\">\n Next\n <\/button>\n <\/div>\n <\/div>\n <\/li>\n <\/ul>\n <ul class=\"form-section\" style=\"display:none;\">\n <li id=\"cid_44\" class=\"form-input-wide\">\n <div class=\"form-header-group\">\n <h2 id=\"header_44\" class=\"form-header\">\n Employment\/ Information\n <\/h2>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_38\">\n <label class=\"form-label-left\" id=\"label_38\" for=\"input_38\"> Employer\/Organization: <\/label>\n <div id=\"cid_38\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_38\" name=\"q38_employerorganization\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_35\">\n <label class=\"form-label-left\" id=\"label_35\" for=\"input_35\"> Position: <\/label>\n <div id=\"cid_35\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_35\" name=\"q35_position\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_92\">\n <label class=\"form-label-left\" id=\"label_92\" for=\"input_92\"> Company Address: <\/label>\n <div id=\"cid_92\" class=\"form-input\">\n <table summary=\"\" class=\"form-address-table\" border=\"0\" cellpadding=\"0\" cellspacing=\"0\">\n <tr>\n <td colspan=\"2\"><span class=\"form-sub-label-container\"><input class=\"form-textbox form-address-line\" type=\"text\" name=\"q92_companyAddress92[addr_line1]\" id=\"input_92_addr_line1\" \/>\n <label class=\"form-sub-label\" for=\"input_92_addr_line1\" id=\"sublabel_addr_line1\"> Street Address <\/label><\/span>\n <\/td>\n <\/tr>\n <tr>\n <td colspan=\"2\"><span class=\"form-sub-label-container\"><input class=\"form-textbox form-address-line\" type=\"text\" name=\"q92_companyAddress92[addr_line2]\" id=\"input_92_addr_line2\" size=\"46\" \/>\n <label class=\"form-sub-label\" for=\"input_92_addr_line2\" id=\"sublabel_addr_line2\"> Street Address Line 2 <\/label><\/span>\n <\/td>\n <\/tr>\n <tr>\n <td width=\"50%\"><span class=\"form-sub-label-container\"><input class=\"form-textbox form-address-city\" type=\"text\" name=\"q92_companyAddress92[city]\" id=\"input_92_city\" size=\"21\" \/>\n <label class=\"form-sub-label\" for=\"input_92_city\" id=\"sublabel_city\"> City <\/label><\/span>\n <\/td>\n <td><span class=\"form-sub-label-container\"><input class=\"form-textbox form-address-state\" type=\"text\" name=\"q92_companyAddress92[state]\" id=\"input_92_state\" size=\"22\" \/>\n <label class=\"form-sub-label\" for=\"input_92_state\" id=\"sublabel_state\"> State \/ Province <\/label><\/span>\n <\/td>\n <\/tr>\n <tr>\n <td width=\"50%\"><span class=\"form-sub-label-container\"><input class=\"form-textbox form-address-postal\" type=\"text\" name=\"q92_companyAddress92[postal]\" id=\"input_92_postal\" size=\"10\" \/>\n <label class=\"form-sub-label\" for=\"input_92_postal\" id=\"sublabel_postal\"> Postal \/ Zip Code <\/label><\/span>\n <\/td>\n <td><span class=\"form-sub-label-container\"><select class=\"form-dropdown form-address-country\" name=\"q92_companyAddress92[country]\" id=\"input_92_country\">\n <option selected> Please Select <\/option>\n <option value=\"United States\"> United States <\/option>\n <option value=\"Abkhazia\"> Abkhazia <\/option>\n <option value=\"Afghanistan\"> Afghanistan <\/option>\n <option value=\"Albania\"> Albania <\/option>\n <option value=\"Algeria\"> Algeria <\/option>\n <option value=\"American Samoa\"> American Samoa <\/option>\n <option value=\"Andorra\"> Andorra <\/option>\n <option value=\"Angola\"> Angola <\/option>\n <option value=\"Anguilla\"> Anguilla <\/option>\n <option value=\"Antigua and Barbuda\"> Antigua and Barbuda <\/option>\n <option value=\"Argentina\"> Argentina <\/option>\n <option value=\"Armenia\"> Armenia <\/option>\n <option value=\"Aruba\"> Aruba <\/option>\n <option value=\"Australia\"> Australia <\/option>\n <option value=\"Austria\"> Austria <\/option>\n <option value=\"Azerbaijan\"> Azerbaijan <\/option>\n <option value=\"The Bahamas\"> The Bahamas <\/option>\n <option value=\"Bahrain\"> Bahrain <\/option>\n <option value=\"Bangladesh\"> Bangladesh <\/option>\n <option value=\"Barbados\"> Barbados <\/option>\n <option value=\"Belarus\"> Belarus <\/option>\n <option value=\"Belgium\"> Belgium <\/option>\n <option value=\"Belize\"> Belize <\/option>\n <option value=\"Benin\"> Benin <\/option>\n <option value=\"Bermuda\"> Bermuda <\/option>\n <option value=\"Bhutan\"> Bhutan <\/option>\n <option value=\"Bolivia\"> Bolivia <\/option>\n <option value=\"Bosnia and Herzegovina\"> Bosnia and Herzegovina <\/option>\n <option value=\"Botswana\"> Botswana <\/option>\n <option value=\"Brazil\"> Brazil <\/option>\n <option value=\"Brunei\"> Brunei <\/option>\n <option value=\"Bulgaria\"> Bulgaria <\/option>\n <option value=\"Burkina Faso\"> Burkina Faso <\/option>\n <option value=\"Burundi\"> Burundi <\/option>\n <option value=\"Cambodia\"> Cambodia <\/option>\n <option value=\"Cameroon\"> Cameroon <\/option>\n <option value=\"Canada\"> Canada <\/option>\n <option value=\"Cape Verde\"> Cape Verde <\/option>\n <option value=\"Cayman Islands\"> Cayman Islands <\/option>\n <option value=\"Central African Republic\"> Central African Republic <\/option>\n <option value=\"Chad\"> Chad <\/option>\n <option value=\"Chile\"> Chile <\/option>\n <option value=\"People's Republic of China\"> People's Republic of China <\/option>\n <option value=\"Republic of China\"> Republic of China <\/option>\n <option value=\"Christmas Island\"> Christmas Island <\/option>\n <option value=\"Cocos (Keeling) Islands\"> Cocos (Keeling) Islands <\/option>\n <option value=\"Colombia\"> Colombia <\/option>\n <option value=\"Comoros\"> Comoros <\/option>\n <option value=\"Congo\"> Congo <\/option>\n <option value=\"Cook Islands\"> Cook Islands <\/option>\n <option value=\"Costa Rica\"> Costa Rica <\/option>\n <option value=\"Cote d'Ivoire\"> Cote d'Ivoire <\/option>\n <option value=\"Croatia\"> Croatia <\/option>\n <option value=\"Cuba\"> Cuba <\/option>\n <option value=\"Cyprus\"> Cyprus <\/option>\n <option value=\"Czech Republic\"> Czech Republic <\/option>\n <option value=\"Denmark\"> Denmark <\/option>\n <option value=\"Djibouti\"> Djibouti <\/option>\n <option value=\"Dominica\"> Dominica <\/option>\n <option value=\"Dominican Republic\"> Dominican Republic <\/option>\n <option value=\"Ecuador\"> Ecuador <\/option>\n <option value=\"Egypt\"> Egypt <\/option>\n <option value=\"El Salvador\"> El Salvador <\/option>\n <option value=\"Equatorial Guinea\"> Equatorial Guinea <\/option>\n <option value=\"Eritrea\"> Eritrea <\/option>\n <option value=\"Estonia\"> Estonia <\/option>\n <option value=\"Ethiopia\"> Ethiopia <\/option>\n <option value=\"Falkland Islands\"> Falkland Islands <\/option>\n <option value=\"Faroe Islands\"> Faroe Islands <\/option>\n <option value=\"Fiji\"> Fiji <\/option>\n <option value=\"Finland\"> Finland <\/option>\n <option value=\"France\"> France <\/option>\n <option value=\"French Polynesia\"> French Polynesia <\/option>\n <option value=\"Gabon\"> Gabon <\/option>\n <option value=\"The Gambia\"> The Gambia <\/option>\n <option value=\"Georgia\"> Georgia <\/option>\n <option value=\"Germany\"> Germany <\/option>\n <option value=\"Ghana\"> Ghana <\/option>\n <option value=\"Gibraltar\"> Gibraltar <\/option>\n <option value=\"Greece\"> Greece <\/option>\n <option value=\"Greenland\"> Greenland <\/option>\n <option value=\"Grenada\"> Grenada <\/option>\n <option value=\"Guadeloupe\"> Guadeloupe <\/option>\n <option value=\"Guam\"> Guam <\/option>\n <option value=\"Guatemala\"> Guatemala <\/option>\n <option value=\"Guernsey\"> Guernsey <\/option>\n <option value=\"Guinea\"> Guinea <\/option>\n <option value=\"Guinea-Bissau\"> Guinea-Bissau <\/option>\n <option value=\"Guyana\"> Guyana <\/option>\n <option value=\"Haiti\"> Haiti <\/option>\n <option value=\"Honduras\"> Honduras <\/option>\n <option value=\"Hong Kong\"> Hong Kong <\/option>\n <option value=\"Hungary\"> Hungary <\/option>\n <option value=\"Iceland\"> Iceland <\/option>\n <option value=\"India\"> India <\/option>\n <option value=\"Indonesia\"> Indonesia <\/option>\n <option value=\"Iran\"> Iran <\/option>\n <option value=\"Iraq\"> Iraq <\/option>\n <option value=\"Ireland\"> Ireland <\/option>\n <option value=\"Israel\"> Israel <\/option>\n <option value=\"Italy\"> Italy <\/option>\n <option value=\"Jamaica\"> Jamaica <\/option>\n <option value=\"Japan\"> Japan <\/option>\n <option value=\"Jersey\"> Jersey <\/option>\n <option value=\"Jordan\"> Jordan <\/option>\n <option value=\"Kazakhstan\"> Kazakhstan <\/option>\n <option value=\"Kenya\"> Kenya <\/option>\n <option value=\"Kiribati\"> Kiribati <\/option>\n <option value=\"North Korea\"> North Korea <\/option>\n <option value=\"South Korea\"> South Korea <\/option>\n <option value=\"Kosovo\"> Kosovo <\/option>\n <option value=\"Kuwait\"> Kuwait <\/option>\n <option value=\"Kyrgyzstan\"> Kyrgyzstan <\/option>\n <option value=\"Laos\"> Laos <\/option>\n <option value=\"Latvia\"> Latvia <\/option>\n <option value=\"Lebanon\"> Lebanon <\/option>\n <option value=\"Lesotho\"> Lesotho <\/option>\n <option value=\"Liberia\"> Liberia <\/option>\n <option value=\"Libya\"> Libya <\/option>\n <option value=\"Liechtenstein\"> Liechtenstein <\/option>\n <option value=\"Lithuania\"> Lithuania <\/option>\n <option value=\"Luxembourg\"> Luxembourg <\/option>\n <option value=\"Macau\"> Macau <\/option>\n <option value=\"Macedonia\"> Macedonia <\/option>\n <option value=\"Madagascar\"> Madagascar <\/option>\n <option value=\"Malawi\"> Malawi <\/option>\n <option value=\"Malaysia\"> Malaysia <\/option>\n <option value=\"Maldives\"> Maldives <\/option>\n <option value=\"Mali\"> Mali <\/option>\n <option value=\"Malta\"> Malta <\/option>\n <option value=\"Marshall Islands\"> Marshall Islands <\/option>\n <option value=\"Martinique\"> Martinique <\/option>\n <option value=\"Mauritania\"> Mauritania <\/option>\n <option value=\"Mauritius\"> Mauritius <\/option>\n <option value=\"Mayotte\"> Mayotte <\/option>\n <option value=\"Mexico\"> Mexico <\/option>\n <option value=\"Micronesia\"> Micronesia <\/option>\n <option value=\"Moldova\"> Moldova <\/option>\n <option value=\"Monaco\"> Monaco <\/option>\n <option value=\"Mongolia\"> Mongolia <\/option>\n <option value=\"Montenegro\"> Montenegro <\/option>\n <option value=\"Montserrat\"> Montserrat <\/option>\n <option value=\"Morocco\"> Morocco <\/option>\n <option value=\"Mozambique\"> Mozambique <\/option>\n <option value=\"Myanmar\"> Myanmar <\/option>\n <option value=\"Nagorno-Karabakh\"> Nagorno-Karabakh <\/option>\n <option value=\"Namibia\"> Namibia <\/option>\n <option value=\"Nauru\"> Nauru <\/option>\n <option value=\"Nepal\"> Nepal <\/option>\n <option value=\"Netherlands\"> Netherlands <\/option>\n <option value=\"Netherlands Antilles\"> Netherlands Antilles <\/option>\n <option value=\"New Caledonia\"> New Caledonia <\/option>\n <option value=\"New Zealand\"> New Zealand <\/option>\n <option value=\"Nicaragua\"> Nicaragua <\/option>\n <option value=\"Niger\"> Niger <\/option>\n <option value=\"Nigeria\"> Nigeria <\/option>\n <option value=\"Niue\"> Niue <\/option>\n <option value=\"Norfolk Island\"> Norfolk Island <\/option>\n <option value=\"Turkish Republic of Northern Cyprus\"> Turkish Republic of Northern Cyprus <\/option>\n <option value=\"Northern Mariana\"> Northern Mariana <\/option>\n <option value=\"Norway\"> Norway <\/option>\n <option value=\"Oman\"> Oman <\/option>\n <option value=\"Pakistan\"> Pakistan <\/option>\n <option value=\"Palau\"> Palau <\/option>\n <option value=\"Palestine\"> Palestine <\/option>\n <option value=\"Panama\"> Panama <\/option>\n <option value=\"Papua New Guinea\"> Papua New Guinea <\/option>\n <option value=\"Paraguay\"> Paraguay <\/option>\n <option value=\"Peru\"> Peru <\/option>\n <option value=\"Philippines\"> Philippines <\/option>\n <option value=\"Pitcairn Islands\"> Pitcairn Islands <\/option>\n <option value=\"Poland\"> Poland <\/option>\n <option value=\"Portugal\"> Portugal <\/option>\n <option value=\"Puerto Rico\"> Puerto Rico <\/option>\n <option value=\"Qatar\"> Qatar <\/option>\n <option value=\"Romania\"> Romania <\/option>\n <option value=\"Russia\"> Russia <\/option>\n <option value=\"Rwanda\"> Rwanda <\/option>\n <option value=\"Saint Barthelemy\"> Saint Barthelemy <\/option>\n <option value=\"Saint Helena\"> Saint Helena <\/option>\n <option value=\"Saint Kitts and Nevis\"> Saint Kitts and Nevis <\/option>\n <option value=\"Saint Lucia\"> Saint Lucia <\/option>\n <option value=\"Saint Martin\"> Saint Martin <\/option>\n <option value=\"Saint Pierre and Miquelon\"> Saint Pierre and Miquelon <\/option>\n <option value=\"Saint Vincent and the Grenadines\"> Saint Vincent and the Grenadines <\/option>\n <option value=\"Samoa\"> Samoa <\/option>\n <option value=\"San Marino\"> San Marino <\/option>\n <option value=\"Sao Tome and Principe\"> Sao Tome and Principe <\/option>\n <option value=\"Saudi Arabia\"> Saudi Arabia <\/option>\n <option value=\"Senegal\"> Senegal <\/option>\n <option value=\"Serbia\"> Serbia <\/option>\n <option value=\"Seychelles\"> Seychelles <\/option>\n <option value=\"Sierra Leone\"> Sierra Leone <\/option>\n <option value=\"Singapore\"> Singapore <\/option>\n <option value=\"Slovakia\"> Slovakia <\/option>\n <option value=\"Slovenia\"> Slovenia <\/option>\n <option value=\"Solomon Islands\"> Solomon Islands <\/option>\n <option value=\"Somalia\"> Somalia <\/option>\n <option value=\"Somaliland\"> Somaliland <\/option>\n <option value=\"South Africa\"> South Africa <\/option>\n <option value=\"South Ossetia\"> South Ossetia <\/option>\n <option value=\"Spain\"> Spain <\/option>\n <option value=\"Sri Lanka\"> Sri Lanka <\/option>\n <option value=\"Sudan\"> Sudan <\/option>\n <option value=\"Suriname\"> Suriname <\/option>\n <option value=\"Svalbard\"> Svalbard <\/option>\n <option value=\"Swaziland\"> Swaziland <\/option>\n <option value=\"Sweden\"> Sweden <\/option>\n <option value=\"Switzerland\"> Switzerland <\/option>\n <option value=\"Syria\"> Syria <\/option>\n <option value=\"Taiwan\"> Taiwan <\/option>\n <option value=\"Tajikistan\"> Tajikistan <\/option>\n <option value=\"Tanzania\"> Tanzania <\/option>\n <option value=\"Thailand\"> Thailand <\/option>\n <option value=\"Timor-Leste\"> Timor-Leste <\/option>\n <option value=\"Togo\"> Togo <\/option>\n <option value=\"Tokelau\"> Tokelau <\/option>\n <option value=\"Tonga\"> Tonga <\/option>\n <option value=\"Transnistria Pridnestrovie\"> Transnistria Pridnestrovie <\/option>\n <option value=\"Trinidad and Tobago\"> Trinidad and Tobago <\/option>\n <option value=\"Tristan da Cunha\"> Tristan da Cunha <\/option>\n <option value=\"Tunisia\"> Tunisia <\/option>\n <option value=\"Turkey\"> Turkey <\/option>\n <option value=\"Turkmenistan\"> Turkmenistan <\/option>\n <option value=\"Turks and Caicos Islands\"> Turks and Caicos Islands <\/option>\n <option value=\"Tuvalu\"> Tuvalu <\/option>\n <option value=\"Uganda\"> Uganda <\/option>\n <option value=\"Ukraine\"> Ukraine <\/option>\n <option value=\"United Arab Emirates\"> United Arab Emirates <\/option>\n <option value=\"United Kingdom\"> United Kingdom <\/option>\n <option value=\"Uruguay\"> Uruguay <\/option>\n <option value=\"Uzbekistan\"> Uzbekistan <\/option>\n <option value=\"Vanuatu\"> Vanuatu <\/option>\n <option value=\"Vatican City\"> Vatican City <\/option>\n <option value=\"Venezuela\"> Venezuela <\/option>\n <option value=\"Vietnam\"> Vietnam <\/option>\n <option value=\"British Virgin Islands\"> British Virgin Islands <\/option>\n <option value=\"US Virgin Islands\"> US Virgin Islands <\/option>\n <option value=\"Wallis and Futuna\"> Wallis and Futuna <\/option>\n <option value=\"Western Sahara\"> Western Sahara <\/option>\n <option value=\"Yemen\"> Yemen <\/option>\n <option value=\"Zambia\"> Zambia <\/option>\n <option value=\"Zimbabwe\"> Zimbabwe <\/option>\n <option value=\"other\"> Other <\/option>\n <\/select>\n <label class=\"form-sub-label\" for=\"input_92_country\" id=\"sublabel_country\"> Country <\/label><\/span>\n <\/td>\n <\/tr>\n <\/table>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_90\">\n <label class=\"form-label-left\" id=\"label_90\" for=\"input_90\"> Business Phone: <\/label>\n <div id=\"cid_90\" class=\"form-input\"><span class=\"form-sub-label-container\"><input class=\"form-textbox\" type=\"tel\" name=\"q90_businessPhone90[area]\" id=\"input_90_area\" size=\"3\">\n -\n <label class=\"form-sub-label\" for=\"input_90_area\" id=\"sublabel_area\"> Area Code <\/label><\/span><span class=\"form-sub-label-container\"><input class=\"form-textbox\" type=\"tel\" name=\"q90_businessPhone90[phone]\" id=\"input_90_phone\" size=\"8\">\n <label class=\"form-sub-label\" for=\"input_90_phone\" id=\"sublabel_phone\"> Phone Number <\/label><\/span>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_91\">\n <label class=\"form-label-left\" id=\"label_91\" for=\"input_91\"> Fax: <\/label>\n <div id=\"cid_91\" class=\"form-input\"><span class=\"form-sub-label-container\"><input class=\"form-textbox\" type=\"tel\" name=\"q91_fax[area]\" id=\"input_91_area\" size=\"3\">\n -\n <label class=\"form-sub-label\" for=\"input_91_area\" id=\"sublabel_area\"> Area Code <\/label><\/span><span class=\"form-sub-label-container\"><input class=\"form-textbox\" type=\"tel\" name=\"q91_fax[phone]\" id=\"input_91_phone\" size=\"8\">\n <label class=\"form-sub-label\" for=\"input_91_phone\" id=\"sublabel_phone\"> Phone Number <\/label><\/span>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_28\">\n <label class=\"form-label-left\" id=\"label_28\" for=\"input_28\"> Supervisor's Name: <\/label>\n <div id=\"cid_28\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_28\" name=\"q28_supervisorsName\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li id=\"cid_47\" class=\"form-input-wide\">\n <div class=\"form-pagebreak\">\n <div class=\"form-pagebreak-back-container form-label-left\">\n <button type=\"button\" class=\"form-pagebreak-back\" id=\"form-pagebreak-back_47\">\n Back\n <\/button>\n <\/div>\n <div class=\"form-pagebreak-next-container\">\n <button type=\"button\" class=\"form-pagebreak-next\" id=\"form-pagebreak-next_47\">\n Next\n <\/button>\n <\/div>\n <\/div>\n <\/li>\n <\/ul>\n <ul class=\"form-section\" style=\"display:none;\">\n <li id=\"cid_48\" class=\"form-input-wide\">\n <div class=\"form-header-group\">\n <h2 id=\"header_48\" class=\"form-header\">\n JA Volunteer Experience\n <\/h2>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_93\">\n <label class=\"form-label-left\" id=\"label_93\" for=\"input_93\"> Have You Taught JA Before? <\/label>\n <div id=\"cid_93\" class=\"form-input\">\n <select class=\"form-dropdown\" style=\"width:150px\" id=\"input_93\" name=\"q93_haveYou93\">\n <option> <\/option>\n <option value=\"Yes\"> Yes <\/option>\n <option value=\"No\"> No <\/option>\n <\/select>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_94\">\n <label class=\"form-label-left\" id=\"label_94\" for=\"input_94\"> Grades Taught: <\/label>\n <div id=\"cid_94\" class=\"form-input\">\n <div class=\"form-single-column\"><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox\" id=\"input_94_0\" name=\"q94_gradesTaught[]\" value=\"Elementary (K-5th)\" \/>\n <label for=\"input_94_0\"> Elementary (K-5th) <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox\" id=\"input_94_1\" name=\"q94_gradesTaught[]\" value=\"Middle (6th-8th)\" \/>\n <label for=\"input_94_1\"> Middle (6th-8th) <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox\" id=\"input_94_2\" name=\"q94_gradesTaught[]\" value=\"High School (9th-12th)\" \/>\n <label for=\"input_94_2\"> High School (9th-12th) <\/label><\/span><span class=\"clearfix\"><\/span>\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_49\">\n <label class=\"form-label-left\" id=\"label_49\" for=\"input_49\"> Ja Alumni? <\/label>\n <div id=\"cid_49\" class=\"form-input\">\n <div class=\"form-single-column\"><span class=\"form-radio-item\" style=\"clear:left;\"><input type=\"radio\" class=\"form-radio\" id=\"input_49_0\" name=\"q49_jaAlumni49\" value=\"Yes\" \/>\n <label for=\"input_49_0\"> Yes <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-radio-item\" style=\"clear:left;\"><input type=\"radio\" class=\"form-radio\" id=\"input_49_1\" name=\"q49_jaAlumni49\" value=\"No\" \/>\n <label for=\"input_49_1\"> No <\/label><\/span><span class=\"clearfix\"><\/span>\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_51\">\n <label class=\"form-label-left\" id=\"label_51\" for=\"input_51\"> Other Community Involvement: <\/label>\n <div id=\"cid_51\" class=\"form-input\">\n <textarea id=\"input_51\" class=\"form-textarea\" name=\"q51_otherCommunity51\" cols=\"20\" rows=\"2\"><\/textarea>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_40\">\n <label class=\"form-label-left\" id=\"label_40\" for=\"input_40\"> Are you interested in other JA Volunteer Opportunities? <\/label>\n <div id=\"cid_40\" class=\"form-input\">\n <div class=\"form-single-column\"><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox\" id=\"input_40_0\" name=\"q40_areYou[]\" value=\"JA Bowl-a-Thon\" \/>\n <label for=\"input_40_0\"> JA Bowl-a-Thon <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox\" id=\"input_40_1\" name=\"q40_areYou[]\" value=\"Golf Tournament\" \/>\n <label for=\"input_40_1\"> Golf Tournament <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox\" id=\"input_40_2\" name=\"q40_areYou[]\" value=\"JA Train the Trainer\" \/>\n <label for=\"input_40_2\"> JA Train the Trainer <\/label><\/span><span class=\"clearfix\"><\/span>\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_95\">\n <label class=\"form-label-left\" id=\"label_95\" for=\"input_95\"> .... <\/label>\n <div id=\"cid_95\" class=\"form-input\">\n <div class=\"form-single-column\"><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox\" id=\"input_95_0\" name=\"q95_95[]\" value=\"I am interested in financially supporting JA through a PERSONAL donation!\" \/>\n <label for=\"input_95_0\"> I am interested in financially supporting JA through a PERSONAL donation! <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox\" id=\"input_95_1\" name=\"q95_95[]\" value=\"I am interested in financially supporting JA through a CORPORATE donation!\" \/>\n <label for=\"input_95_1\"> I am interested in financially supporting JA through a CORPORATE donation! <\/label><\/span><span class=\"clearfix\"><\/span>\n <\/div>\n <\/div>\n <\/li>\n <li id=\"cid_59\" class=\"form-input-wide\">\n <div class=\"form-pagebreak\">\n <div class=\"form-pagebreak-back-container form-label-left\">\n <button type=\"button\" class=\"form-pagebreak-back\" id=\"form-pagebreak-back_59\">\n Back\n <\/button>\n <\/div>\n <div class=\"form-pagebreak-next-container\">\n <button type=\"button\" class=\"form-pagebreak-next\" id=\"form-pagebreak-next_59\">\n Next\n <\/button>\n <\/div>\n <\/div>\n <\/li>\n <\/ul>\n <ul class=\"form-section\" style=\"display:none;\">\n <li class=\"form-line\" id=\"id_96\">\n <div id=\"cid_96\" class=\"form-input-wide\">\n <div id=\"text_96\" class=\"form-html\">\n <p style=\"text-align: center;\"><span style=\"font-size: small;\"><span style=\"font-family: arial, helvetica, sans-serif; color: black; font-size: large; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\"><span style=\"mso-list: Ignore;\"><strong><span style=\"line-height: 115%;\">Consultant Responsibilities and Conduct Standards<\/span>\n <\/strong><\/span><\/span><\/span>\n <\/p>\n <p><span style=\"font-size: medium;\"><strong>\n Consultant Responsibilities:\n <\/strong><\/span>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span style=\"font-family: Symbol; color: black; font-size: 12pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\">·<\/span><span>Contact assigned teacher.<\/span>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span style=\"font-family: Symbol; color: black; font-size: 12pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\">·<\/span><span>Agree on date\/time of class.\n <strong>\n Inform teacher at least one day in advance\n <\/strong><\/span>\n <strong><span>if you need to reschedule. <\/span>\n <\/strong>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span style=\"font-family: Symbol; color: black; font-size: 12pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\">·<\/span><span>Become familiar with school procedures. <\/span>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span style=\"font-family: Symbol; color: black; font-size: 12pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\">·<\/span><span>Enter through main office and sign appropriate volunteer binder.  <\/span>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span style=\"font-family: Symbol; color: black; font-size: 12pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\">·<\/span><span>Arrive early for each class session.<\/span>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span style=\"font-family: Symbol; color: black; font-size: 12pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\">·<\/span><span>Agree to Junior Achievement-Consultant\/Volunteer Conduct Standards.<\/span>\n <\/p>\n <p><span style=\"font-size: medium;\"><strong>\n Consultant\/Volunteer Conduct Standards:\n <\/strong><\/span>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span>Junior Achievement serves youth. Our volunteers teach valuable lessons with each word and especially with their conduct. Adult misconduct with youth carries serious consequences. Because Junior Achievement cares that its volunteer have healthy relationships with the youth they serve, it has established these standards.<\/span>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span><span>\ufeff<\/span><\/span>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span style=\"font-family: Symbol; color: black; font-size: 12pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\">·<\/span><span>Young people look to adults for examples of appropriate behavior. JA<\/span><span>volunteers must use  appropriate language and model behavior, such as<\/span><span>respect, integrity, honesty, and excellence.<\/span>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span><span>\ufeff<\/span><\/span>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span style=\"font-family: Symbol; color: black; font-size: 12pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\">·<\/span><span>Profanity, sexual language or jokes is inappropriate behavior around<\/span><span>students. <\/span>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span><span>\ufeff<\/span><\/span>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span style=\"font-family: Symbol; color: black; font-size: 12pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\">·<\/span><span>Violating state laws regarding interactions with youth, e.g., providing them<\/span><span>alcohol or illegal drugs is forbidden.<\/span>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span><span>\ufeff<\/span><\/span>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span style=\"font-family: Symbol; color: black; font-size: 12pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\">·<\/span><span>Volunteers must take particular care when touching youth. Most people<\/span><span>understand the difference between appropriate touching, like a handshake or<\/span><span>a pat on the back and touching which is sexual or disrespectful. <\/span>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span><span>\ufeff<\/span><\/span>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span style=\"font-family: Symbol; color: black; font-size: 12pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\">·<\/span><span>Volunteers must also consider how any physical contact may be perceived.<\/span><span><span style=\"mso-spacerun: yes;\"><\/span>\n Interactions with students must both be appropriate and appear appropriate.<\/span>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span><span>\ufeff<\/span><\/span>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span style=\"font-family: Symbol; color: black; font-size: 12pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\">·<\/span><span>Volunteers will spend time with groups of students, although occasionally one-<\/span><span>to-one situations may occur. Prior to any one-to-one interaction, a JA<\/span><span>volunteer generally should ensure another adult is present or aware of the<\/span><span>situation.  <\/span>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span style=\"font-family: Symbol; color: black; font-size: 12pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\">·<\/span><span>Favoritism or the appearance of favoritism should be avoided.<\/span>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span><span>\ufeff<\/span><\/span>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span style=\"font-family: Symbol; color: black; font-size: 12pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\">·<\/span><span>Volunteers are responsible for the quality of the interactions. Students often<\/span><span>find it difficult to state discomfort or objections. <\/span>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span><span>\ufeff<\/span><\/span>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span style=\"font-family: Symbol; color: black; font-size: 12pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\">·<\/span><span>Volunteers must be especially sensitive to physical and verbal cues that youth<\/span><span>provide.<\/span>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span><span>\ufeff<\/span><\/span>\n <\/p>\n <p class=\"MsoNormal\" style=\"line-height: normal; margin: 0in 0in 0pt;\"><span>These are examples only, not a comprehensive list. Other actions not listed could result in suspension or dismissal as a volunteer.<\/span>\n <\/p>\n <\/p>\n <p class=\"MsoNormal\" style=\"text-align: left; line-height: normal; margin: 0in 0in 0pt;\"><span style=\"line-height: 115%;\">Junior Achievement will take all complaints of misconduct seriously. Credible allegations of misconduct will be properly investigated by the appropriate authorities. If the investigation determines that misconduct occurred, it will result in the immediate and permanent dismissal as a JA volunteer. Any JA staff member or volunteer who reasonably suspects misconduct must report these suspicions immediately to the appropriate JA staff person at the local office.<\/span>\n <\/p>\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_66\">\n <label class=\"form-label-left\" id=\"label_66\" for=\"input_66\">\n Required<span class=\"form-required\">*<\/span>\n <\/label>\n <div id=\"cid_66\" class=\"form-input\">\n <div class=\"form-single-column\"><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_66_0\" name=\"q66_required[]\" value=\"Yes, I agree that I have read the above Consultant Responsibilities and Conduct Standards and understand that my submission will act as my signature.\" \/>\n <label for=\"input_66_0\"> Yes, I agree that I have read the above Consultant Responsibilities and Conduct Standards and understand that my submission will act as my signature. <\/label><\/span><span class=\"clearfix\"><\/span>\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_81\">\n <div id=\"cid_81\" class=\"form-input-wide\">\n <div id=\"text_81\" class=\"form-html\">\n I hereby certify that I have never been charged with a crime of violence or a crime involving a child or young person,or, if I have I have fully disclosed in writing the facts regarding such a charge to the local Junior Achievement office.\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_80\">\n <label class=\"form-label-left\" id=\"label_80\" for=\"input_80\">\n Required<span class=\"form-required\">*<\/span>\n <\/label>\n <div id=\"cid_80\" class=\"form-input\">\n <div class=\"form-single-column\"><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_80_0\" name=\"q80_required80[]\" value=\"I have NEVER been charged with a crime of violence or a crime involving a child or young person.\" \/>\n <label for=\"input_80_0\"> I have NEVER been charged with a crime of violence or a crime involving a child or young person. <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_80_1\" name=\"q80_required80[]\" value=\"I have been charged with a crime of violence or a crime involving a child or young person.\" \/>\n <label for=\"input_80_1\"> I have been charged with a crime of violence or a crime involving a child or young person. <\/label><\/span><span class=\"clearfix\"><\/span>\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_67\">\n <div id=\"cid_67\" class=\"form-input-wide\">\n <div id=\"text_67\" class=\"form-html\">\n <div>\n <table style=\"background-color: #ffffff; width: 400px; border-collapse: separate;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n <tbody>\n <tr>\n <td style=\"padding: 5px;\">\n Have you ever been convicted or had adjudication withheld in a criminal offense other than a minor traffic violation or are there any criminal charges now pending against you other than a minor traffic violation? \n <br \/>\n <\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n <\/div>\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_68\">\n <label class=\"form-label-left\" id=\"label_68\" for=\"input_68\">\n Required<span class=\"form-required\">*<\/span>\n <\/label>\n <div id=\"cid_68\" class=\"form-input\">\n <div class=\"form-single-column\"><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_68_0\" name=\"q68_required68[]\" value=\"Yes, I have been convicted of a criminal offense.\" \/>\n <label for=\"input_68_0\"> Yes, I have been convicted of a criminal offense. <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_68_1\" name=\"q68_required68[]\" value=\"No, I have never been convicted or had adjudication withheld in a criminal offense and there are no charges pending against me.\" \/>\n <label for=\"input_68_1\"> No, I have never been convicted or had adjudication withheld in a criminal offense and there are no charges pending against me. <\/label><\/span><span class=\"clearfix\"><\/span>\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_70\">\n <div id=\"cid_70\" class=\"form-input-wide\">\n <div id=\"text_70\" class=\"form-html\">\n <div>\n <table style=\"background-color: #ffffff; width: 400px; border-collapse: separate;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n <tbody>\n <tr>\n <td style=\"padding: 5px;\">\n Demographic information collected by JA is used for statistical purposes only. It is not used for individuals, but used only in aggregate form. JA is a non-profit organization that applies for grants and funding from various entities. In these applications, we need to provide statistical information to demonstrate that JA reflects the diversity of the communities we serve.  We appreciate your assistance in ensuring JA’s continued service to our children.\n <\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n <\/div>\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_71\">\n <label class=\"form-label-left\" id=\"label_71\" for=\"input_71\"> Ethnic Background: <\/label>\n <div id=\"cid_71\" class=\"form-input\">\n <select class=\"form-dropdown\" style=\"width:150px\" id=\"input_71\" name=\"q71_ethnicBackground\">\n <option> <\/option>\n <option value=\"African American\"> African American <\/option>\n <option value=\"Alaskan Native\"> Alaskan Native <\/option>\n <option value=\"American Indian\"> American Indian <\/option>\n <option value=\"Asian\"> Asian <\/option>\n <option value=\"Caucasian\"> Caucasian <\/option>\n <option value=\"Hawaiian\"> Hawaiian <\/option>\n <option value=\"Hispanic\"> Hispanic <\/option>\n <\/select>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_72\">\n <label class=\"form-label-left\" id=\"label_72\" for=\"input_72\">\n Gender:<span class=\"form-required\">*<\/span>\n <\/label>\n <div id=\"cid_72\" class=\"form-input\">\n <select class=\"form-dropdown validate[required]\" style=\"width:150px\" id=\"input_72\" name=\"q72_gender72\">\n <option> <\/option>\n <option value=\"Male\"> Male <\/option>\n <option value=\"Female\"> Female <\/option>\n <\/select>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_77\">\n <label class=\"form-label-left\" id=\"label_77\" for=\"input_77\"> Birth Date: <\/label>\n <div id=\"cid_77\" class=\"form-input\"><span class=\"form-sub-label-container\"><select class=\"form-dropdown\" name=\"q77_birthDate[month]\" id=\"input_77_month\">\n <option> <\/option>\n <option value=\"January\"> January <\/option>\n <option value=\"February\"> February <\/option>\n <option value=\"March\"> March <\/option>\n <option value=\"April\"> April <\/option>\n <option value=\"May\"> May <\/option>\n <option value=\"June\"> June <\/option>\n <option value=\"July\"> July <\/option>\n <option value=\"August\"> August <\/option>\n <option value=\"September\"> September <\/option>\n <option value=\"October\"> October <\/option>\n <option value=\"November\"> November <\/option>\n <option value=\"December\"> December <\/option>\n <\/select>\n <label class=\"form-sub-label\" for=\"input_77_month\" id=\"sublabel_month\"> Month <\/label><\/span><span class=\"form-sub-label-container\"><select class=\"form-dropdown\" name=\"q77_birthDate[day]\" id=\"input_77_day\">\n <option> <\/option>\n <option value=\"1\"> 1 <\/option>\n <option value=\"2\"> 2 <\/option>\n <option value=\"3\"> 3 <\/option>\n <option value=\"4\"> 4 <\/option>\n <option value=\"5\"> 5 <\/option>\n <option value=\"6\"> 6 <\/option>\n <option value=\"7\"> 7 <\/option>\n <option value=\"8\"> 8 <\/option>\n <option value=\"9\"> 9 <\/option>\n <option value=\"10\"> 10 <\/option>\n <option value=\"11\"> 11 <\/option>\n <option value=\"12\"> 12 <\/option>\n <option value=\"13\"> 13 <\/option>\n <option value=\"14\"> 14 <\/option>\n <option value=\"15\"> 15 <\/option>\n <option value=\"16\"> 16 <\/option>\n <option value=\"17\"> 17 <\/option>\n <option value=\"18\"> 18 <\/option>\n <option value=\"19\"> 19 <\/option>\n <option value=\"20\"> 20 <\/option>\n <option value=\"21\"> 21 <\/option>\n <option value=\"22\"> 22 <\/option>\n <option value=\"23\"> 23 <\/option>\n <option value=\"24\"> 24 <\/option>\n <option value=\"25\"> 25 <\/option>\n <option value=\"26\"> 26 <\/option>\n <option value=\"27\"> 27 <\/option>\n <option value=\"28\"> 28 <\/option>\n <option value=\"29\"> 29 <\/option>\n <option value=\"30\"> 30 <\/option>\n <option value=\"31\"> 31 <\/option>\n <\/select>\n <label class=\"form-sub-label\" for=\"input_77_day\" id=\"sublabel_day\"> Day <\/label><\/span><span class=\"form-sub-label-container\"><select class=\"form-dropdown\" name=\"q77_birthDate[year]\" id=\"input_77_year\">\n <option> <\/option>\n <option value=\"2016\"> 2016 <\/option>\n <option value=\"2015\"> 2015 <\/option>\n <option value=\"2014\"> 2014 <\/option>\n <option value=\"2013\"> 2013 <\/option>\n <option value=\"2012\"> 2012 <\/option>\n <option value=\"2011\"> 2011 <\/option>\n <option value=\"2010\"> 2010 <\/option>\n <option value=\"2009\"> 2009 <\/option>\n <option value=\"2008\"> 2008 <\/option>\n <option value=\"2007\"> 2007 <\/option>\n <option value=\"2006\"> 2006 <\/option>\n <option value=\"2005\"> 2005 <\/option>\n <option value=\"2004\"> 2004 <\/option>\n <option value=\"2003\"> 2003 <\/option>\n <option value=\"2002\"> 2002 <\/option>\n <option value=\"2001\"> 2001 <\/option>\n <option value=\"2000\"> 2000 <\/option>\n <option value=\"1999\"> 1999 <\/option>\n <option value=\"1998\"> 1998 <\/option>\n <option value=\"1997\"> 1997 <\/option>\n <option value=\"1996\"> 1996 <\/option>\n <option value=\"1995\"> 1995 <\/option>\n <option value=\"1994\"> 1994 <\/option>\n <option value=\"1993\"> 1993 <\/option>\n <option value=\"1992\"> 1992 <\/option>\n <option value=\"1991\"> 1991 <\/option>\n <option value=\"1990\"> 1990 <\/option>\n <option value=\"1989\"> 1989 <\/option>\n <option value=\"1988\"> 1988 <\/option>\n <option value=\"1987\"> 1987 <\/option>\n <option value=\"1986\"> 1986 <\/option>\n <option value=\"1985\"> 1985 <\/option>\n <option value=\"1984\"> 1984 <\/option>\n <option value=\"1983\"> 1983 <\/option>\n <option value=\"1982\"> 1982 <\/option>\n <option value=\"1981\"> 1981 <\/option>\n <option value=\"1980\"> 1980 <\/option>\n <option value=\"1979\"> 1979 <\/option>\n <option value=\"1978\"> 1978 <\/option>\n <option value=\"1977\"> 1977 <\/option>\n <option value=\"1976\"> 1976 <\/option>\n <option value=\"1975\"> 1975 <\/option>\n <option value=\"1974\"> 1974 <\/option>\n <option value=\"1973\"> 1973 <\/option>\n <option value=\"1972\"> 1972 <\/option>\n <option value=\"1971\"> 1971 <\/option>\n <option value=\"1970\"> 1970 <\/option>\n <option value=\"1969\"> 1969 <\/option>\n <option value=\"1968\"> 1968 <\/option>\n <option value=\"1967\"> 1967 <\/option>\n <option value=\"1966\"> 1966 <\/option>\n <option value=\"1965\"> 1965 <\/option>\n <option value=\"1964\"> 1964 <\/option>\n <option value=\"1963\"> 1963 <\/option>\n <option value=\"1962\"> 1962 <\/option>\n <option value=\"1961\"> 1961 <\/option>\n <option value=\"1960\"> 1960 <\/option>\n <option value=\"1959\"> 1959 <\/option>\n <option value=\"1958\"> 1958 <\/option>\n <option value=\"1957\"> 1957 <\/option>\n <option value=\"1956\"> 1956 <\/option>\n <option value=\"1955\"> 1955 <\/option>\n <option value=\"1954\"> 1954 <\/option>\n <option value=\"1953\"> 1953 <\/option>\n <option value=\"1952\"> 1952 <\/option>\n <option value=\"1951\"> 1951 <\/option>\n <option value=\"1950\"> 1950 <\/option>\n <option value=\"1949\"> 1949 <\/option>\n <option value=\"1948\"> 1948 <\/option>\n <option value=\"1947\"> 1947 <\/option>\n <option value=\"1946\"> 1946 <\/option>\n <option value=\"1945\"> 1945 <\/option>\n <option value=\"1944\"> 1944 <\/option>\n <option value=\"1943\"> 1943 <\/option>\n <option value=\"1942\"> 1942 <\/option>\n <option value=\"1941\"> 1941 <\/option>\n <option value=\"1940\"> 1940 <\/option>\n <option value=\"1939\"> 1939 <\/option>\n <option value=\"1938\"> 1938 <\/option>\n <option value=\"1937\"> 1937 <\/option>\n <option value=\"1936\"> 1936 <\/option>\n <option value=\"1935\"> 1935 <\/option>\n <option value=\"1934\"> 1934 <\/option>\n <option value=\"1933\"> 1933 <\/option>\n <option value=\"1932\"> 1932 <\/option>\n <option value=\"1931\"> 1931 <\/option>\n <option value=\"1930\"> 1930 <\/option>\n <option value=\"1929\"> 1929 <\/option>\n <option value=\"1928\"> 1928 <\/option>\n <option value=\"1927\"> 1927 <\/option>\n <option value=\"1926\"> 1926 <\/option>\n <option value=\"1925\"> 1925 <\/option>\n <option value=\"1924\"> 1924 <\/option>\n <option value=\"1923\"> 1923 <\/option>\n <option value=\"1922\"> 1922 <\/option>\n <option value=\"1921\"> 1921 <\/option>\n <option value=\"1920\"> 1920 <\/option>\n <\/select>\n <label class=\"form-sub-label\" for=\"input_77_year\" id=\"sublabel_year\"> Year <\/label><\/span>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_97\">\n <label class=\"form-label-left\" id=\"label_97\" for=\"input_97\"> Highest Level of Education: <\/label>\n <div id=\"cid_97\" class=\"form-input\">\n <select class=\"form-dropdown\" style=\"width:150px\" id=\"input_97\" name=\"q97_highestLevel97\">\n <option> <\/option>\n <option value=\"High School Diploma\"> High School Diploma <\/option>\n <option value=\"Associates Degree\"> Associates Degree <\/option>\n <option value=\"Bachelors Degree\"> Bachelors Degree <\/option>\n <option value=\"Masters Degree\"> Masters Degree <\/option>\n <option value=\"Doctorate Degree\"> Doctorate Degree <\/option>\n <\/select>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_74\">\n <label class=\"form-label-left\" id=\"label_74\" for=\"input_74\"> Income Level (optional): <\/label>\n <div id=\"cid_74\" class=\"form-input\">\n <select class=\"form-dropdown\" style=\"width:150px\" id=\"input_74\" name=\"q74_incomeLevel\">\n <option> <\/option>\n <option value=\"Under $30,000\"> Under $30,000 <\/option>\n <option value=\"$31,000-$50,000\"> $31,000-$50,000 <\/option>\n <option value=\"$51,000-$100,000\"> $51,000-$100,000 <\/option>\n <option value=\"More than $100,000\"> More than $100,000 <\/option>\n <\/select>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_79\">\n <div id=\"cid_79\" class=\"form-input-wide\">\n <div id=\"text_79\" class=\"form-html\">\n <p><span style=\"font-size: medium;\">I understand that this will serve as my electronic signature and that I acknowledge that the information provided herein is correct.<\/span>\n <\/p>\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_101\">\n <div id=\"cid_101\" class=\"form-input-wide\">\n <div style=\"text-align:center\" class=\"form-buttons-wrapper\">\n <button id=\"input_101\" type=\"submit\" class=\"form-submit-button\">\n I have read the Conduct Standards and understand that my submission acts as my signature.\n <\/button>\n <\/div>\n <\/div>\n <\/li>\n <li style=\"display:none\">\n Should be Empty:\n <input type=\"text\" name=\"website\" value=\"\" \/>\n <\/li>\n <\/ul>\n <\/div>\n <input type=\"hidden\" id=\"simple_spc\" name=\"simple_spc\" value=\"2002202210\" \/>\n <script type=\"text\/javascript\">\n document.getElementById(\"si\" + \"mple\" + \"_spc\").value = \"2002202210-2002202210\";\n <\/script>\n<\/form><\/body>\n<\/html>\n");