/*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 i92140137897 = new FrameBuilder("92140137897", false, "", "\n\n\n\n\nForm<\/title>\n<link href=\"http:\/\/max.jotfor.ms\/min\/g=formCss?3.0.2422\" rel=\"stylesheet\" type=\"text\/css\" \/>\n<style type=\"text\/css\">\n .form-label{\n width:140px !important;\n }\n .form-label-left{\n width:140px !important;\n }\n .form-line{\n padding:5px;\n }\n .form-label-right{\n width:140px !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:610px;\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?3.0.2422\" type=\"text\/javascript\"><\/script>\n<script type=\"text\/javascript\">\n var jsTime = setInterval(function(){try{\n JotForm.jsForm = true;\n\n JotForm.init();\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\" enctype=\"multipart\/form-data\" name=\"form_92140137897\" id=\"92140137897\" accept-charset=\"utf-8\">\n <input type=\"hidden\" name=\"formID\" value=\"92140137897\" \/>\n <div class=\"form-all\">\n <ul class=\"form-section\">\n <li class=\"form-line\" id=\"id_121\">\n <div id=\"cid_121\" class=\"form-input-wide\">\n <div id=\"text_121\" class=\"form-html\">\n Please Note: DO NOT hit \"enter\" after filling out a field. Doing so will submit the application. \n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_0\">\n <label class=\"form-label-left\" id=\"label_0\" for=\"input_0\"> Position Desired <\/label>\n <div id=\"cid_0\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_0\" name=\"q0_positionDesired\" size=\"30\" maxlength=\"255\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_3\">\n <label class=\"form-label-left\" id=\"label_3\" for=\"input_3\"> Salary Range Desired <\/label>\n <div id=\"cid_3\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_3\" name=\"q3_salaryRange\" size=\"30\" maxlength=\"255\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_4\">\n <label class=\"form-label-left\" id=\"label_4\" for=\"input_4\">\n How did you learn about this position (e.g. newspaper ad, friend, etc.)?<span class=\"form-required\">*<\/span>\n <\/label>\n <div id=\"cid_4\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox validate[required]\" id=\"input_4\" name=\"q4_howDid\" size=\"30\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_16\">\n <label class=\"form-label-left\" id=\"label_16\" for=\"input_16\"> Your Name <\/label>\n <div id=\"cid_16\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_16\" name=\"q16_yourName\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_123\">\n <label class=\"form-label-left\" id=\"label_123\" for=\"input_123\"> Address <\/label>\n <div id=\"cid_123\" 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=\"q123_address123[addr_line1]\" id=\"input_123_addr_line1\" \/>\n <label class=\"form-sub-label\" for=\"input_123_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=\"q123_address123[addr_line2]\" id=\"input_123_addr_line2\" size=\"46\" \/>\n <label class=\"form-sub-label\" for=\"input_123_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=\"q123_address123[city]\" id=\"input_123_city\" size=\"21\" \/>\n <label class=\"form-sub-label\" for=\"input_123_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=\"q123_address123[state]\" id=\"input_123_state\" size=\"22\" \/>\n <label class=\"form-sub-label\" for=\"input_123_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=\"q123_address123[postal]\" id=\"input_123_postal\" size=\"10\" \/>\n <label class=\"form-sub-label\" for=\"input_123_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=\"q123_address123[country]\" id=\"input_123_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=\"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\"> Guyana Guyana <\/option>\n <option value=\"Haiti Haiti\"> 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=\"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=\"Transnistria Pridnestrovie\"> Transnistria Pridnestrovie <\/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=\"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_123_country\" id=\"sublabel_country\"> Country <\/label><\/span>\n <\/td>\n <\/tr>\n <\/table>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_18\">\n <label class=\"form-label-left\" id=\"label_18\" for=\"input_18\"> Home Phone <\/label>\n <div id=\"cid_18\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_18\" name=\"q18_homePhone\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_19\">\n <label class=\"form-label-left\" id=\"label_19\" for=\"input_19\"> Cell Phone <\/label>\n <div id=\"cid_19\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_19\" name=\"q19_cellPhone\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_21\">\n <label class=\"form-label-left\" id=\"label_21\" for=\"input_21\"> Permanent Address (if different than above) <\/label>\n <div id=\"cid_21\" class=\"form-input\">\n <textarea id=\"input_21\" class=\"form-textarea\" name=\"q21_permanentAddress\" cols=\"30\" rows=\"2\"><\/textarea>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_22\">\n <label class=\"form-label-left\" id=\"label_22\" for=\"input_22\"> Email <\/label>\n <div id=\"cid_22\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_22\" name=\"q22_email\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_24\">\n <label class=\"form-label-left\" id=\"label_24\" for=\"input_24\"> If hired, when could you begin working with us? <\/label>\n <div id=\"cid_24\" class=\"form-input\">\n <textarea id=\"input_24\" class=\"form-textarea\" name=\"q24_ifHired\" cols=\"30\" rows=\"2\"><\/textarea>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_25\">\n <label class=\"form-label-left\" id=\"label_25\" for=\"input_25\"> Please list\/describe experience and training relevant to the position for which you are applying <\/label>\n <div id=\"cid_25\" class=\"form-input\">\n <textarea id=\"input_25\" class=\"form-textarea\" name=\"q25_pleaseListdescribe\" cols=\"40\" rows=\"12\"><\/textarea>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_26\">\n <label class=\"form-label-left\" id=\"label_26\" for=\"input_26\"> Explain your interest in the position for which you are applying <\/label>\n <div id=\"cid_26\" class=\"form-input\">\n <textarea id=\"input_26\" class=\"form-textarea\" name=\"q26_explainYour\" cols=\"40\" rows=\"5\"><\/textarea>\n <\/div>\n <\/li>\n <li id=\"cid_27\" class=\"form-input-wide\">\n <div class=\"form-header-group\">\n <h2 id=\"header_27\" class=\"form-header\">\n Education\n <\/h2>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_28\">\n <label class=\"form-label-left\" id=\"label_28\" for=\"input_28\"> 1. School Attended <\/label>\n <div id=\"cid_28\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_28\" name=\"q28_1School\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_31\">\n <label class=\"form-label-left\" id=\"label_31\" for=\"input_31\"> Degree Earned <\/label>\n <div id=\"cid_31\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_31\" name=\"q31_degreeEarned\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_124\">\n <label class=\"form-label-left\" id=\"label_124\" for=\"input_124\"> Date of Completion <\/label>\n <div id=\"cid_124\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_124\" name=\"q124_dateOf\" size=\"20\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_32\">\n <label class=\"form-label-left\" id=\"label_32\" for=\"input_32\"> 2. School Attended <\/label>\n <div id=\"cid_32\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_32\" name=\"q32_2School\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_33\">\n <label class=\"form-label-left\" id=\"label_33\" for=\"input_33\"> Degree Earned <\/label>\n <div id=\"cid_33\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_33\" name=\"q33_degreeEarned33\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_125\">\n <label class=\"form-label-left\" id=\"label_125\" for=\"input_125\"> Date of Completion <\/label>\n <div id=\"cid_125\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_125\" name=\"q125_dateOf125\" size=\"20\" \/>\n <\/div>\n <\/li>\n <li id=\"cid_36\" class=\"form-input-wide\">\n <div class=\"form-header-group\">\n <h2 id=\"header_36\" class=\"form-header\">\n Work Experience\n <\/h2>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_37\">\n <div id=\"cid_37\" class=\"form-input-wide\">\n <div id=\"text_37\" class=\"form-html\">\n begin with current or most recent position\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_39\">\n <label class=\"form-label-left\" id=\"label_39\" for=\"input_39\"> 1. Employer <\/label>\n <div id=\"cid_39\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_39\" name=\"q39_1Employer\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_46\">\n <label class=\"form-label-left\" id=\"label_46\" for=\"input_46\"> Title <\/label>\n <div id=\"cid_46\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_46\" name=\"q46_title\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_42\">\n <label class=\"form-label-left\" id=\"label_42\" for=\"input_42\"> Dates of Employment <\/label>\n <div id=\"cid_42\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_42\" name=\"q42_datesOf\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_47\">\n <label class=\"form-label-left\" id=\"label_47\" for=\"input_47\"> Salary <\/label>\n <div id=\"cid_47\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_47\" name=\"q47_salary\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_48\">\n <label class=\"form-label-left\" id=\"label_48\" for=\"input_48\"> Responsibilities <\/label>\n <div id=\"cid_48\" class=\"form-input\">\n <textarea id=\"input_48\" class=\"form-textarea\" name=\"q48_responsibilities\" cols=\"30\" rows=\"2\"><\/textarea>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_44\">\n <label class=\"form-label-left\" id=\"label_44\" for=\"input_44\"> Phone <\/label>\n <div id=\"cid_44\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_44\" name=\"q44_phone\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_41\">\n <label class=\"form-label-left\" id=\"label_41\" for=\"input_41\"> City\/State <\/label>\n <div id=\"cid_41\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_41\" name=\"q41_citystate\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_43\">\n <label class=\"form-label-left\" id=\"label_43\" for=\"input_43\"> Reason for Leaving <\/label>\n <div id=\"cid_43\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_43\" name=\"q43_reasonFor\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_51\">\n <label class=\"form-label-left\" id=\"label_51\" for=\"input_51\"> 2. Employer <\/label>\n <div id=\"cid_51\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_51\" name=\"q51_2Employer\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_59\">\n <label class=\"form-label-left\" id=\"label_59\" for=\"input_59\"> Title <\/label>\n <div id=\"cid_59\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_59\" name=\"q59_title59\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_57\">\n <label class=\"form-label-left\" id=\"label_57\" for=\"input_57\"> Dates of Employment <\/label>\n <div id=\"cid_57\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_57\" name=\"q57_datesOf57\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_60\">\n <label class=\"form-label-left\" id=\"label_60\" for=\"input_60\"> Salary <\/label>\n <div id=\"cid_60\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_60\" name=\"q60_salary60\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_61\">\n <label class=\"form-label-left\" id=\"label_61\" for=\"input_61\"> Responsibilities <\/label>\n <div id=\"cid_61\" class=\"form-input\">\n <textarea id=\"input_61\" class=\"form-textarea\" name=\"q61_responsibilities61\" cols=\"30\" rows=\"2\"><\/textarea>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_52\">\n <label class=\"form-label-left\" id=\"label_52\" for=\"input_52\"> Phone <\/label>\n <div id=\"cid_52\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_52\" name=\"q52_phone52\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_55\">\n <label class=\"form-label-left\" id=\"label_55\" for=\"input_55\"> City\/State <\/label>\n <div id=\"cid_55\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_55\" name=\"q55_citystate55\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_58\">\n <label class=\"form-label-left\" id=\"label_58\" for=\"input_58\"> Reason for Leaving <\/label>\n <div id=\"cid_58\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_58\" name=\"q58_reasonFor58\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_62\">\n <label class=\"form-label-left\" id=\"label_62\" for=\"input_62\"> 3. Employer <\/label>\n <div id=\"cid_62\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_62\" name=\"q62_3Employer\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_70\">\n <label class=\"form-label-left\" id=\"label_70\" for=\"input_70\"> Title <\/label>\n <div id=\"cid_70\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_70\" name=\"q70_title70\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_68\">\n <label class=\"form-label-left\" id=\"label_68\" for=\"input_68\"> Dates of Employment <\/label>\n <div id=\"cid_68\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_68\" name=\"q68_datesOf68\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_71\">\n <label class=\"form-label-left\" id=\"label_71\" for=\"input_71\"> Salary <\/label>\n <div id=\"cid_71\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_71\" name=\"q71_salary71\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_72\">\n <label class=\"form-label-left\" id=\"label_72\" for=\"input_72\"> Responsibilities <\/label>\n <div id=\"cid_72\" class=\"form-input\">\n <textarea id=\"input_72\" class=\"form-textarea\" name=\"q72_responsibilities72\" cols=\"30\" rows=\"2\"><\/textarea>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_64\">\n <label class=\"form-label-left\" id=\"label_64\" for=\"input_64\"> Phone <\/label>\n <div id=\"cid_64\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_64\" name=\"q64_phone64\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_66\">\n <label class=\"form-label-left\" id=\"label_66\" for=\"input_66\"> City\/State <\/label>\n <div id=\"cid_66\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_66\" name=\"q66_citystate66\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_69\">\n <label class=\"form-label-left\" id=\"label_69\" for=\"input_69\"> Reason for Leaving <\/label>\n <div id=\"cid_69\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_69\" name=\"q69_reasonFor69\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_73\">\n <label class=\"form-label-left\" id=\"label_73\" for=\"input_73\"> May we contact all of the aforementioned employers? <\/label>\n <div id=\"cid_73\" 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_73_0\" name=\"q73_mayWe\" value=\"Yes\" \/>\n <label for=\"input_73_0\"> Yes <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-radio-item\" style=\"clear:left;\"><input type=\"radio\" class=\"form-radio\" id=\"input_73_1\" name=\"q73_mayWe\" value=\"No\" \/>\n <label for=\"input_73_1\"> No <\/label><\/span><span class=\"clearfix\"><\/span>\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_75\">\n <label class=\"form-label-left\" id=\"label_75\" for=\"input_75\"> If not, please indicate which employers you do not wish us to contact <\/label>\n <div id=\"cid_75\" class=\"form-input\">\n <textarea id=\"input_75\" class=\"form-textarea\" name=\"q75_ifNot\" cols=\"30\" rows=\"2\"><\/textarea>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_76\">\n <label class=\"form-label-left\" id=\"label_76\" for=\"input_76\"> If current certification within the last 12 months of any of the following, please indicate <\/label>\n <div id=\"cid_76\" 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_76_0\" name=\"q76_ifCurrent[]\" value=\"CPR Infant\/Child\" \/>\n <label for=\"input_76_0\"> CPR Infant\/Child <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox\" id=\"input_76_1\" name=\"q76_ifCurrent[]\" value=\"CPR Adult\" \/>\n <label for=\"input_76_1\"> CPR Adult <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox\" id=\"input_76_2\" name=\"q76_ifCurrent[]\" value=\"First Aid\" \/>\n <label for=\"input_76_2\"> First Aid <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox\" id=\"input_76_3\" name=\"q76_ifCurrent[]\" value=\"Crisis Prevention\" \/>\n <label for=\"input_76_3\"> Crisis Prevention <\/label><\/span><span class=\"clearfix\"><\/span>\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_77\">\n <label class=\"form-label-left\" id=\"label_77\" for=\"input_77\"> Other certifications <\/label>\n <div id=\"cid_77\" class=\"form-input\">\n <textarea id=\"input_77\" class=\"form-textarea\" name=\"q77_otherCertifications\" cols=\"30\" rows=\"2\"><\/textarea>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_78\">\n <label class=\"form-label-left\" id=\"label_78\" for=\"input_78\"> Can you provide documentation of attendance of the above training(s)? <\/label>\n <div id=\"cid_78\" 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_78_0\" name=\"q78_canYou\" value=\"Yes\" \/>\n <label for=\"input_78_0\"> Yes <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-radio-item\" style=\"clear:left;\"><input type=\"radio\" class=\"form-radio\" id=\"input_78_1\" name=\"q78_canYou\" value=\"No\" \/>\n <label for=\"input_78_1\"> No <\/label><\/span><span class=\"clearfix\"><\/span>\n <\/div>\n <\/div>\n <\/li>\n <li id=\"cid_79\" class=\"form-input-wide\">\n <div class=\"form-header-group\">\n <h2 id=\"header_79\" class=\"form-header\">\n Professional References\n <\/h2>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_80\">\n <div id=\"cid_80\" class=\"form-input-wide\">\n <div id=\"text_80\" class=\"form-html\">\n do not list relatives or friends\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_82\">\n <label class=\"form-label-left\" id=\"label_82\" for=\"input_82\"> 1. Name <\/label>\n <div id=\"cid_82\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_82\" name=\"q82_1Name\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_83\">\n <label class=\"form-label-left\" id=\"label_83\" for=\"input_83\"> Relationship <\/label>\n <div id=\"cid_83\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_83\" name=\"q83_relationship\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_88\">\n <label class=\"form-label-left\" id=\"label_88\" for=\"input_88\"> Business Name <\/label>\n <div id=\"cid_88\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_88\" name=\"q88_businessName\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_89\">\n <label class=\"form-label-left\" id=\"label_89\" for=\"input_89\"> Email <\/label>\n <div id=\"cid_89\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_89\" name=\"q89_email89\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_90\">\n <label class=\"form-label-left\" id=\"label_90\" for=\"input_90\"> Work Phone <\/label>\n <div id=\"cid_90\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_90\" name=\"q90_workPhone\" 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\"> Home Phone <\/label>\n <div id=\"cid_92\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_92\" name=\"q92_homePhone92\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_93\">\n <label class=\"form-label-left\" id=\"label_93\" for=\"input_93\"> 2. Name <\/label>\n <div id=\"cid_93\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_93\" name=\"q93_2Name\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_94\">\n <label class=\"form-label-left\" id=\"label_94\" for=\"input_94\"> Relationship <\/label>\n <div id=\"cid_94\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_94\" name=\"q94_relationship94\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_99\">\n <label class=\"form-label-left\" id=\"label_99\" for=\"input_99\"> Business Name <\/label>\n <div id=\"cid_99\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_99\" name=\"q99_businessName99\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_100\">\n <label class=\"form-label-left\" id=\"label_100\" for=\"input_100\"> Email <\/label>\n <div id=\"cid_100\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_100\" name=\"q100_email100\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_101\">\n <label class=\"form-label-left\" id=\"label_101\" for=\"input_101\"> Work Phone <\/label>\n <div id=\"cid_101\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_101\" name=\"q101_workPhone101\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_102\">\n <label class=\"form-label-left\" id=\"label_102\" for=\"input_102\"> Home Phone <\/label>\n <div id=\"cid_102\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_102\" name=\"q102_homePhone102\" size=\"20\" maxlength=\"100\" \/>\n <\/div>\n <\/li>\n <li id=\"cid_103\" class=\"form-input-wide\">\n <div class=\"form-header-group\">\n <h2 id=\"header_103\" class=\"form-header\">\n Additional Information\n <\/h2>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_104\">\n <label class=\"form-label-left\" id=\"label_104\" for=\"input_104\"> Have you ever been convicted of a crime, felony or misdemeanor, of any type? <\/label>\n <div id=\"cid_104\" 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_104_0\" name=\"q104_haveYou\" value=\"Yes\" \/>\n <label for=\"input_104_0\"> Yes <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-radio-item\" style=\"clear:left;\"><input type=\"radio\" class=\"form-radio\" id=\"input_104_1\" name=\"q104_haveYou\" value=\"No\" \/>\n <label for=\"input_104_1\"> No <\/label><\/span><span class=\"clearfix\"><\/span>\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_105\">\n <label class=\"form-label-left\" id=\"label_105\" for=\"input_105\"> If yes, please give dates and circumstances <\/label>\n <div id=\"cid_105\" class=\"form-input\">\n <textarea id=\"input_105\" class=\"form-textarea\" name=\"q105_ifYes\" cols=\"30\" rows=\"2\"><\/textarea>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_106\">\n <label class=\"form-label-left\" id=\"label_106\" for=\"input_106\"> Are you at least 18 years of age? <\/label>\n <div id=\"cid_106\" 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_106_0\" name=\"q106_areYou\" value=\"Yes\" \/>\n <label for=\"input_106_0\"> Yes <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-radio-item\" style=\"clear:left;\"><input type=\"radio\" class=\"form-radio\" id=\"input_106_1\" name=\"q106_areYou\" value=\"No\" \/>\n <label for=\"input_106_1\"> No <\/label><\/span><span class=\"clearfix\"><\/span>\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_107\">\n <label class=\"form-label-left\" id=\"label_107\" for=\"input_107\">\n Have you ever worked for or applied for employment and\/or volunteer opportunities with St. David's before?<span class=\"form-required\">*<\/span>\n <\/label>\n <div id=\"cid_107\" class=\"form-input\">\n <div class=\"form-single-column\"><span class=\"form-radio-item\" style=\"clear:left;\"><input type=\"radio\" class=\"form-radio validate[required]\" id=\"input_107_0\" name=\"q107_haveYou107\" value=\"No\" \/>\n <label for=\"input_107_0\"> No <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-radio-item\" style=\"clear:left;\"><input type=\"radio\" class=\"form-radio validate[required]\" id=\"input_107_1\" name=\"q107_haveYou107\" value=\"Yes, former employee\" \/>\n <label for=\"input_107_1\"> Yes, former employee <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-radio-item\" style=\"clear:left;\"><input type=\"radio\" class=\"form-radio validate[required]\" id=\"input_107_2\" name=\"q107_haveYou107\" value=\"Yes, current employee\" \/>\n <label for=\"input_107_2\"> Yes, current employee <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-radio-item\" style=\"clear:left;\"><input type=\"radio\" class=\"form-radio validate[required]\" id=\"input_107_3\" name=\"q107_haveYou107\" value=\"Yes, past applicant\" \/>\n <label for=\"input_107_3\"> Yes, past applicant <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-radio-item\" style=\"clear:left;\"><input type=\"radio\" class=\"form-radio validate[required]\" id=\"input_107_4\" name=\"q107_haveYou107\" value=\"Yes, intern\" \/>\n <label for=\"input_107_4\"> Yes, intern <\/label><\/span><span class=\"clearfix\"><\/span>\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_108\">\n <label class=\"form-label-left\" id=\"label_108\" for=\"input_108\"> If yes, please give dates and details <\/label>\n <div id=\"cid_108\" class=\"form-input\">\n <textarea id=\"input_108\" class=\"form-textarea\" name=\"q108_ifYes108\" cols=\"30\" rows=\"2\"><\/textarea>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_109\">\n <label class=\"form-label-left\" id=\"label_109\" for=\"input_109\"> Are you legally authorized to work in the United States? <\/label>\n <div id=\"cid_109\" 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_109_0\" name=\"q109_areYou109\" value=\"Yes\" \/>\n <label for=\"input_109_0\"> Yes <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-radio-item\" style=\"clear:left;\"><input type=\"radio\" class=\"form-radio\" id=\"input_109_1\" name=\"q109_areYou109\" value=\"No\" \/>\n <label for=\"input_109_1\"> No <\/label><\/span><span class=\"clearfix\"><\/span>\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_110\">\n <div id=\"cid_110\" class=\"form-input-wide\">\n <div id=\"text_110\" class=\"form-html\">\n I understand that if I am hired, my continued employment will depend upon results of a criminal Background Study. This will be done through a Background Study form from the Division of Licensing for the State of Minnesota and\/or the Minnesota Bureau of Apprehension Background Study. Specific information will be required of me in order to process the Background Study form.\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_117\">\n <div id=\"cid_117\" class=\"form-input-wide\">\n <div id=\"text_117\" class=\"form-html\">\n I understand if I am offered employment I authorize St. David's Center for Child & Family Development to investigate my current or previous academic, employment, experience and qualifications, driving and criminal records and to release to St. David\u2019s Center any information pertinent to my potential employment.\n <BR>\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_118\">\n <div id=\"cid_118\" class=\"form-input-wide\">\n <div id=\"text_118\" class=\"form-html\">\n I authorize investigation of all statements contained herein, and the reference listed above to give you any and all information concerning my previous employment, and any pertinent information they may have, personal or otherwise. I release all parties from all liability for any damage that may result from furnishing this information to you.\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_119\">\n <div id=\"cid_119\" class=\"form-input-wide\">\n <div id=\"text_119\" class=\"form-html\">\n I understand and agree that, if hired, my employment is for an indefinite period of time, and may be terminated with or without cause at any time without liability for wages or salary except such is may have been earned at the date of termination. I further understand that this is an application for employment, and no employment contract is being offered.\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_111\">\n <label class=\"form-label-left\" id=\"label_111\" for=\"input_111\">\n I have read and understand all of the above<span class=\"form-required\">*<\/span>\n <\/label>\n <div id=\"cid_111\" class=\"form-input\">\n <div class=\"form-single-column\"><span class=\"form-radio-item\" style=\"clear:left;\"><input type=\"radio\" class=\"form-radio validate[required]\" id=\"input_111_0\" name=\"q111_iHave111\" value=\"Yes\" \/>\n <label for=\"input_111_0\"> Yes <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-radio-item\" style=\"clear:left;\"><input type=\"radio\" class=\"form-radio validate[required]\" id=\"input_111_1\" name=\"q111_iHave111\" value=\"No\" \/>\n <label for=\"input_111_1\"> No <\/label><\/span><span class=\"clearfix\"><\/span>\n <\/div>\n <\/div>\n <\/li>\n <li id=\"cid_112\" class=\"form-input-wide\">\n <div class=\"form-header-group\">\n <h2 id=\"header_112\" class=\"form-header\">\n Authorization to Release Information\n <\/h2>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_113\">\n <label class=\"form-label-left\" id=\"label_113\" for=\"input_113\">\n I also agree that if I am hired by St. David's Center, I authorize release of this application to county social service agencies for the purpose of fulfilling licensing requirements.<span class=\"form-required\">*<\/span>\n <\/label>\n <div id=\"cid_113\" class=\"form-input\">\n <div class=\"form-single-column\"><span class=\"form-radio-item\" style=\"clear:left;\"><input type=\"radio\" class=\"form-radio validate[required]\" id=\"input_113_0\" name=\"q113_iAlso113\" value=\"Yes\" \/>\n <label for=\"input_113_0\"> Yes <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-radio-item\" style=\"clear:left;\"><input type=\"radio\" class=\"form-radio validate[required]\" id=\"input_113_1\" name=\"q113_iAlso113\" value=\"No\" \/>\n <label for=\"input_113_1\"> No <\/label><\/span><span class=\"clearfix\"><\/span>\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_114\">\n <div id=\"cid_114\" class=\"form-input-wide\">\n <div id=\"text_114\" class=\"form-html\">\n St. David\u2019s Center provides equal employment opportunity to all persons regardless of age, color, national origin, citizenship status, disability, race, religion, creed, gender, sex, sexual orientation, gender identity and\/or expression, marital status, status with regard to public assistance, veteran status or any other status protected by law.\n <\/div>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_115\">\n <label class=\"form-label-left\" id=\"label_115\" for=\"input_115\"> Upload Resume and Cover Letter <\/label>\n <div id=\"cid_115\" class=\"form-input\">\n <input class=\"form-upload\" type=\"file\" id=\"input_115\" name=\"q115_uploadResume115\" file-accept=\"doc, xls, jpg, jpeg, gif, png, mp3, mpeg, pdf, docx\" file-maxsize=\"10000\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_126\">\n <label class=\"form-label-left\" id=\"label_126\" for=\"input_126\"> Signature (please initial) <\/label>\n <div id=\"cid_126\" class=\"form-input\">\n <input type=\"text\" class=\"form-textbox\" id=\"input_126\" name=\"q126_signatureplease\" size=\"20\" \/>\n <\/div>\n <\/li>\n <li class=\"form-line\" id=\"id_116\">\n <div id=\"cid_116\" class=\"form-input-wide\">\n <div style=\"margin-left:146px\" class=\"form-buttons-wrapper\">\n <button id=\"input_116\" type=\"submit\" class=\"form-submit-button\">\n Submit Form\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=\"92140137897\" \/>\n <script type=\"text\/javascript\">\n document.getElementById(\"si\" + \"mple\" + \"_spc\").value = \"92140137897-92140137897\";\n <\/script>\n<\/form><\/body>\n<\/html>\n");