{"id":7724,"date":"2025-03-17T14:51:26","date_gmt":"2025-03-17T19:51:26","guid":{"rendered":"https:\/\/www.wtcsnd.org\/?page_id=7724"},"modified":"2025-06-19T13:56:45","modified_gmt":"2025-06-19T18:56:45","slug":"preschool-prek-admissions","status":"publish","type":"page","link":"https:\/\/www.wtcsnd.org\/?page_id=7724","title":{"rendered":"Preschool &#8211; PreK Admissions"},"content":{"rendered":"\n<style><style><\/style><\/style><style><\/style><div class='rmformui'><div id='rm-form-container' class='rmform-design--default-container'><form id='rmform-module-23' class='rmform-ui rmform-custom-form rmform-custom-form-23 rmform-design--default' action='' method='post' enctype='multipart\/form-data'data-form-id='23' data-design='default' data-style='label_top' data-type='0'><div class='rmform-page'><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-richtext-1053' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1053'><div class=\"rmform-control \" ><p><span style=\"font-weight: 400\">IF YOU ARE COMPLETING REGISTRATION ON YOUR PHONE AND YOU CLICK A LINK, YOUR INFORMATION COULD BE LOST.\u00a0 THE SCHOOL RECOMMENDS COMPLETING REGISTRATION USING A COMPUTER OR LAPTOP.<\/span><\/p><\/div><span class='rmform-error-message' id='rmform-richtext_1053-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-email-1054' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1054'><label for=\"input_id_Email_1054\" id=\"label_id_Email_1054\" class=\"rmform-label\"  >  Account Email<span class='rmform-req-symbol'>*<\/span><\/label><input type=\"email\" name=\"Email_1054\" class=\"rmform-control \" aria-describedby=\"rm-note-1054\" id=\"input_id_Email_1054\" data-fieldtype=\"Email\" aria-labelledby=\"label_id_Email_1054\" value=\"\" placeholder=\"Your email address\" required data-primary=\"1\" aria-required=\"true\"  ><span class='rmform-error-message' id='rmform-email_1054-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-htmlh-1055' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1055'><h1 class=\"rmform-field-type-heading rmform-control \" >Student Information<\/h1><span class='rmform-error-message' id='rmform-htmlh_1055-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1056' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1056'><label for=\"input_id_Textbox_1056\" id=\"label_id_Textbox_1056\" class=\"rmform-label\" >  Student Last Name<span class='rmform-req-symbol'>*<\/span><\/label><input type=\"text\" name=\"Textbox_1056\" class=\"rmform-control \" aria-describedby=\"rm-note-1056\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1056\" aria-labelledby=\"label_id_Textbox_1056\" placeholder=\"\" required aria-required=\"true\"  ><span class='rmform-error-message' id='rmform-textbox_1056-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1057' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1057'><label for=\"input_id_Textbox_1057\" id=\"label_id_Textbox_1057\" class=\"rmform-label\" >  Student First Name<span class='rmform-req-symbol'>*<\/span><\/label><input type=\"text\" name=\"Textbox_1057\" class=\"rmform-control \" aria-describedby=\"rm-note-1057\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1057\" aria-labelledby=\"label_id_Textbox_1057\" placeholder=\"\" required aria-required=\"true\"  ><span class='rmform-error-message' id='rmform-textbox_1057-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1058' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1058'><label for=\"input_id_Textbox_1058\" id=\"label_id_Textbox_1058\" class=\"rmform-label\" >  Middle Name<\/label><input type=\"text\" name=\"Textbox_1058\" class=\"rmform-control \" aria-describedby=\"rm-note-1058\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1058\" aria-labelledby=\"label_id_Textbox_1058\" placeholder=\"\"  ><span class='rmform-error-message' id='rmform-textbox_1058-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-bdate-1059' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1059'><label for=\"input_id_Bdate_1059\" id=\"label_id_Bdate_1059\" class=\"rmform-label\" > Date of Birth<span class='rmform-req-symbol'>*<\/span><\/label><input type=\"text\" name=\"Bdate_1059\" class=\"rmform-control bdaydatepicker\" aria-describedby=\"rm-note-1059\" autocomplete=\"off\" readonly data-dateformat=\"mm\/dd\/yy\" aria-labelledby=\"label_id_Bdate_1059\" id=\"input_id_Bdate_1059\" required_max_range=\"07\/27\/2026\" required_min_range=\"\" placeholder=\"\" required aria-required=\"true\"  ><span class='rmform-error-message' id='rmform-bdate_1059-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-radio-1060' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1060'><span class=\"rmform-label\" > Gender<span class='rmform-req-symbol'>*<\/span><\/span><div class='rmform-field-horizontal-row'><label class='rmform-check' for='Radio_1060_0'><input name=\"Radio_1060\" class=\"rmform-control radio_1060 \" aria-describedby=\"rm-note-1060\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1060_0\" value=\"Male\" aria-labelledby=\"label_id_Radio_1060_0\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1060_0\"  >Male<\/span><\/label><label class='rmform-check' for='Radio_1060_1'><input name=\"Radio_1060\" class=\"rmform-control radio_1060 \" aria-describedby=\"rm-note-1060\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1060_1\" value=\"Female\" aria-labelledby=\"label_id_Radio_1060_1\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1060_1\"  >Female<\/span><\/label><\/div><span class='rmform-error-message' id='rmform-radio_1060-error'><\/span><div id='rm-note-1060' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-select-1061' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1061'><label for=\"input_id_Select_1061\" id=\"label_id_Select_1061\" class=\"rmform-label\" > Grade (Fall of 2025)<span class='rmform-req-symbol'>*<\/span><\/label><select name=\"Select_1061\" class=\"rmform-control select_1061 \" aria-describedby=\"rm-note-1061\" id=\"input_id_Select_1061\" aria-labelledby=\"label_id_Select_1061\" required aria-required=\"true\"  ><option value=''>Select an option<\/option><option value='PreSchool T\/Th (8:30-11:30)'>PreSchool T\/Th (8:30-11:30)<\/option><option value='PreSchool M-Th (8:30-11:30)'>PreSchool M-Th (8:30-11:30)<\/option><option value='PreKindergarten M-Th (8:30-2:30)'>PreKindergarten M-Th (8:30-2:30)<\/option><\/select><span class='rmform-error-message' id='rmform-select_1061-error'><\/span><div id='rm-note-1061' class='rmform-note' style='display: none;'>Grade<\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-richtext-1190' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1190'><div class=\"rmform-control \" ><ul style=\"list-style-type: square\">\r\n<li><span style=\"color: #333399\">To be eligible for preschool, children must be three years old by August 1st. <\/span><\/li>\r\n<li><span style=\"color: #333399\">To be eligible for prekindergarten, children must be four years old by August 1st.<\/span><\/li>\r\n<\/ul><\/div><span class='rmform-error-message' id='rmform-richtext_1190-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-select-1062' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1062'><label for=\"input_id_Select_1062\" id=\"label_id_Select_1062\" class=\"rmform-label\" > Student Status<span class='rmform-req-symbol'>*<\/span><\/label><select name=\"Select_1062\" class=\"rmform-control select_1062 \" aria-describedby=\"rm-note-1062\" id=\"input_id_Select_1062\" aria-labelledby=\"label_id_Select_1062\" required aria-required=\"true\"  ><option value=''>Select an option<\/option><option value='Current Preschool-Prekindergarten Student'>Current Preschool-Prekindergarten Student<\/option><option value='New Child of Alumni'>New Child of Alumni<\/option><option value='New Enrollment'>New Enrollment<\/option><option value='Sibling of Current Student'>Sibling of Current Student<\/option><\/select><script>jQuery(document).ready(function() {jQuery(\".select_1062\").select2();});<\/script><span class='rmform-error-message' id='rmform-select_1062-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-radio-1197' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1197'><span class=\"rmform-label\" > How many siblings that are currently enrolled at WTCS??<\/span><div class='rmform-field-horizontal-row'><label class='rmform-check' for='Radio_1197_0'><input name=\"Radio_1197\" class=\"rmform-control radio_1197  data-conditional-revamp\" aria-describedby=\"rm-note-1197\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" data-cond-option=\"Select_1062\" data-cond-value=\"Sibling of Current Student\" data-cond-operator=\"==\" data-cond-action=\"show\" id=\"Radio_1197_0\" value=\"One\" aria-labelledby=\"label_id_Radio_1197_0\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1197_0\"  >One<\/span><\/label><label class='rmform-check' for='Radio_1197_1'><input name=\"Radio_1197\" class=\"rmform-control radio_1197  data-conditional-revamp\" aria-describedby=\"rm-note-1197\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" data-cond-option=\"Select_1062\" data-cond-value=\"Sibling of Current Student\" data-cond-operator=\"==\" data-cond-action=\"show\" id=\"Radio_1197_1\" value=\"Two\" aria-labelledby=\"label_id_Radio_1197_1\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1197_1\"  >Two<\/span><\/label><label class='rmform-check' for='Radio_1197_2'><input name=\"Radio_1197\" class=\"rmform-control radio_1197  data-conditional-revamp\" aria-describedby=\"rm-note-1197\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" data-cond-option=\"Select_1062\" data-cond-value=\"Sibling of Current Student\" data-cond-operator=\"==\" data-cond-action=\"show\" id=\"Radio_1197_2\" value=\"Three\" aria-labelledby=\"label_id_Radio_1197_2\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1197_2\"  >Three<\/span><\/label><label class='rmform-check' for='Radio_1197_3'><input name=\"Radio_1197\" class=\"rmform-control radio_1197  data-conditional-revamp\" aria-describedby=\"rm-note-1197\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" data-cond-option=\"Select_1062\" data-cond-value=\"Sibling of Current Student\" data-cond-operator=\"==\" data-cond-action=\"show\" id=\"Radio_1197_3\" value=\"Four\" aria-labelledby=\"label_id_Radio_1197_3\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1197_3\"  >Four<\/span><\/label><\/div><span class='rmform-error-message' id='rmform-radio_1197-error'><\/span><div id='rm-note-1197' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1203' class='rmform-col rmform-col-6'><div class='rmform-field' data-field-id='1203'><label for=\"input_id_Textbox_1203\" id=\"label_id_Textbox_1203\" class=\"rmform-label\" >  Name<\/label><input type=\"text\" name=\"Textbox_1203\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1203\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1203\" aria-labelledby=\"label_id_Textbox_1203\" placeholder=\"\" data-cond-option=\"Radio_1197|Radio_1197|Radio_1197|Radio_1197\" data-cond-value=\"One|Two|Three|Four\" data-cond-operator=\"==|==|==|==\" data-cond-action=\"show\" data-cond-comb=\"OR\"  ><span class='rmform-error-message' id='rmform-textbox_1203-error'><\/span><\/div><\/div><div id='rm-textbox-1204' class='rmform-col rmform-col-6'><div class='rmform-field' data-field-id='1204'><label for=\"input_id_Textbox_1204\" id=\"label_id_Textbox_1204\" class=\"rmform-label\" >  Age<\/label><input type=\"text\" name=\"Textbox_1204\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1204\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1204\" aria-labelledby=\"label_id_Textbox_1204\" placeholder=\"\" data-cond-option=\"Radio_1197|Radio_1197|Radio_1197|Radio_1197\" data-cond-value=\"One|Two|Three|Four\" data-cond-operator=\"==|==|==|==\" data-cond-action=\"show\" data-cond-comb=\"OR\"  ><span class='rmform-error-message' id='rmform-textbox_1204-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1198' class='rmform-col rmform-col-6'><div class='rmform-field' data-field-id='1198'><label for=\"input_id_Textbox_1198\" id=\"label_id_Textbox_1198\" class=\"rmform-label\" >  Name<\/label><input type=\"text\" name=\"Textbox_1198\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1198\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1198\" aria-labelledby=\"label_id_Textbox_1198\" placeholder=\"\" data-cond-option=\"Radio_1197|Radio_1197|Radio_1197\" data-cond-value=\"Two|Three|Four\" data-cond-operator=\"==|==|==\" data-cond-action=\"show\" data-cond-comb=\"OR\"  ><span class='rmform-error-message' id='rmform-textbox_1198-error'><\/span><\/div><\/div><div id='rm-textbox-1199' class='rmform-col rmform-col-6'><div class='rmform-field' data-field-id='1199'><label for=\"input_id_Textbox_1199\" id=\"label_id_Textbox_1199\" class=\"rmform-label\" >  Age<\/label><input type=\"text\" name=\"Textbox_1199\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1199\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1199\" aria-labelledby=\"label_id_Textbox_1199\" placeholder=\"\" data-cond-option=\"Radio_1197|Radio_1197|Radio_1197\" data-cond-value=\"Two|Three|Four\" data-cond-operator=\"==|==|==\" data-cond-action=\"show\" data-cond-comb=\"OR\"  ><span class='rmform-error-message' id='rmform-textbox_1199-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1205' class='rmform-col rmform-col-6'><div class='rmform-field' data-field-id='1205'><label for=\"input_id_Textbox_1205\" id=\"label_id_Textbox_1205\" class=\"rmform-label\" >  Name<\/label><input type=\"text\" name=\"Textbox_1205\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1205\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1205\" aria-labelledby=\"label_id_Textbox_1205\" placeholder=\"\" data-cond-option=\"Radio_1197|Radio_1197\" data-cond-value=\"Three|Four\" data-cond-operator=\"==|==\" data-cond-action=\"show\" data-cond-comb=\"OR\"  ><span class='rmform-error-message' id='rmform-textbox_1205-error'><\/span><\/div><\/div><div id='rm-textbox-1206' class='rmform-col rmform-col-6'><div class='rmform-field' data-field-id='1206'><label for=\"input_id_Textbox_1206\" id=\"label_id_Textbox_1206\" class=\"rmform-label\" >  Age<\/label><input type=\"text\" name=\"Textbox_1206\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1206\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1206\" aria-labelledby=\"label_id_Textbox_1206\" placeholder=\"\" data-cond-option=\"Radio_1197|Radio_1197\" data-cond-value=\"Three|Four\" data-cond-operator=\"==|==\" data-cond-action=\"show\" data-cond-comb=\"OR\"  ><span class='rmform-error-message' id='rmform-textbox_1206-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1201' class='rmform-col rmform-col-6'><div class='rmform-field' data-field-id='1201'><label for=\"input_id_Textbox_1201\" id=\"label_id_Textbox_1201\" class=\"rmform-label\" >  Name<\/label><input type=\"text\" name=\"Textbox_1201\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1201\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1201\" aria-labelledby=\"label_id_Textbox_1201\" placeholder=\"\" data-cond-option=\"Radio_1197\" data-cond-value=\"Four\" data-cond-operator=\"==\" data-cond-action=\"show\"  ><span class='rmform-error-message' id='rmform-textbox_1201-error'><\/span><\/div><\/div><div id='rm-textbox-1202' class='rmform-col rmform-col-6'><div class='rmform-field' data-field-id='1202'><label for=\"input_id_Textbox_1202\" id=\"label_id_Textbox_1202\" class=\"rmform-label\" >  Age<\/label><input type=\"text\" name=\"Textbox_1202\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1202\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1202\" aria-labelledby=\"label_id_Textbox_1202\" placeholder=\"\" data-cond-option=\"Radio_1197\" data-cond-value=\"Four\" data-cond-operator=\"==\" data-cond-action=\"show\"  ><span class='rmform-error-message' id='rmform-textbox_1202-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-divider-1207' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1207'><hr class=\"rmform-divider hr\" width=\"100%\" size=\"8\" align=\"center\" ><span class='rmform-error-message' id='rmform-divider_1207-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-address-1063' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1063'><label class=\"rmform-label\" >  Home Address<span class='rmform-req-symbol'>*<\/span><\/label><div class='rmform-row'><div class='rmform-row-field-wrap'><div class='rmform-col rmform-col-12'><div class='rmform-field'><input type=\"text\" class=\"rmform-control\" aria-describedby=\"rm-note-1063\" id=\"input_id_address1_1063\" name=\"Address_1063[address1]\" aria-labelledby=\"label_id_address1_1063\" value=\"\" required aria-required=\"true\"  ><label for='input_id_address1_1063' id='label_id_address1_1063' class='rmform-label rmform-label-address'> Address Line 1<span class='rmform-req-symbol'>*<\/span><\/label><span class='rmform-error-message' id='rmform-address_1063address1-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'><div class='rmform-col rmform-col-12'><div class='rmform-field'><input type=\"text\" class=\"rmform-control\" aria-describedby=\"rm-note-1063\" id=\"input_id_address2_label_1063\" name=\"Address_1063[address2]\" aria-labelledby=\"label_id_address2_label_1063\" value=\"\" ><label for='input_id_address2_label_1063' id='label_id_address2_label_1063' class='rmform-label rmform-label-address'> Address Line 2<\/label><span class='rmform-error-message' id='rmform-address_1063address2-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'><div class='rmform-col rmform-col-6'><div class='rmform-field'><input type=\"text\" class=\"rmform-control\" aria-describedby=\"rm-note-1063\" id=\"input_id_city_label_1063\" name=\"Address_1063[city]\" aria-labelledby=\"label_id_city_label_1063\" value=\"\" required aria-required=\"true\"  ><label for='input_id_city_label_1063' id='label_id_city_label_1063' class='rmform-label rmform-label-address'> City<span class='rmform-req-symbol'>*<\/span><\/label><span class='rmform-error-message' id='rmform-address_1063city-error'><\/span><\/div><\/div><div class='rmform-col rmform-col-6'><div class='rmform-field'><select type=\"text\" class=\"rmform-control\" aria-describedby=\"rm-note-1063\" id=\"input_id_state_label_1063\" name=\"Address_1063[state]\" aria-labelledby=\"label_id_state_label_1063\" value=\"\" required aria-required=\"true\"  ><option value=''>--Select State--<\/option><option value='Alabama'>Alabama<\/option><option value='Alaska'>Alaska<\/option><option value='Arizona'>Arizona<\/option><option value='Arkansas'>Arkansas<\/option><option value='Armed Forces America'>Armed Forces America<\/option><option value='Armed Forces Europe'>Armed Forces Europe<\/option><option value='Armed Forces Pacific'>Armed Forces Pacific<\/option><option value='California'>California<\/option><option value='Colorado'>Colorado<\/option><option value='Connecticut'>Connecticut<\/option><option value='Delaware'>Delaware<\/option><option value='District Of Columbia'>District Of Columbia<\/option><option value='Florida'>Florida<\/option><option value='Georgia'>Georgia<\/option><option value='Hawaii'>Hawaii<\/option><option value='Idaho'>Idaho<\/option><option value='Illinois'>Illinois<\/option><option value='Indiana'>Indiana<\/option><option value='Iowa'>Iowa<\/option><option value='Kansas'>Kansas<\/option><option value='Kentucky'>Kentucky<\/option><option value='Louisiana'>Louisiana<\/option><option value='Maine'>Maine<\/option><option value='Maryland'>Maryland<\/option><option value='Massachusetts'>Massachusetts<\/option><option value='Michigan'>Michigan<\/option><option value='Minnesota'>Minnesota<\/option><option value='Mississippi'>Mississippi<\/option><option value='Missouri'>Missouri<\/option><option value='Montana'>Montana<\/option><option value='Nebraska'>Nebraska<\/option><option value='Nevada'>Nevada<\/option><option value='New Hampshire'>New Hampshire<\/option><option value='New Jersey'>New Jersey<\/option><option value='New Mexico'>New Mexico<\/option><option value='New York'>New York<\/option><option value='North Carolina'>North Carolina<\/option><option value='North Dakota'>North Dakota<\/option><option value='Ohio'>Ohio<\/option><option value='Oklahoma'>Oklahoma<\/option><option value='Oregon'>Oregon<\/option><option value='Pennsylvania'>Pennsylvania<\/option><option value='Rhode Island'>Rhode Island<\/option><option value='South Carolina'>South Carolina<\/option><option value='South Dakota'>South Dakota<\/option><option value='Tennessee'>Tennessee<\/option><option value='Texas'>Texas<\/option><option value='Utah'>Utah<\/option><option value='Vermont'>Vermont<\/option><option value='Virginia'>Virginia<\/option><option value='Washington'>Washington<\/option><option value='West Virginia'>West Virginia<\/option><option value='Wisconsin'>Wisconsin<\/option><option value='Wyoming'>Wyoming<\/option><\/select><label for='input_id_state_label_1063' id='label_id_state_label_1063' class='rmform-label rmform-label-address'>State or Region<span class='rmform-req-symbol'>*<\/span><\/label><span class='rmform-error-message' id='rmform-address_1063state-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'><div class='rmform-col rmform-col-6'><div class='rmform-field'><select type=\"text\" class=\"rmform-control\" aria-describedby=\"rm-note-1063\" id=\"input_id_country_label_1063\" name=\"Address_1063[country]\" aria-labelledby=\"label_id_country_label_1063\" value=\"\" onchange=\"update_state_dropdown(1063)\" required aria-required=\"true\"  ><option value='US'>United States<\/option><option value='Canada'>Canada<\/option><\/select><label for='input_id_country_label_1063' id='label_id_country_label_1063' class='rmform-label rmform-label-address'> Country<span class='rmform-req-symbol'>*<\/span><\/label><span class='rmform-error-message' id='rmform-address_1063country-error'><\/span><\/div><\/div><div class='rmform-col rmform-col-6'><div class='rmform-field'><input type=\"text\" class=\"rmform-control\" aria-describedby=\"rm-note-1063\" id=\"input_id_zip_label_1063\" name=\"Address_1063[zip]\" aria-labelledby=\"label_id_zip_label_1063\" value=\"\" required aria-required=\"true\"  ><label for='input_id_zip_label_1063' id='label_id_zip_label_1063' class='rmform-label rmform-label-address'> Zip<span class='rmform-req-symbol'>*<\/span><\/label><span class='rmform-error-message' id='rmform-address_1063zip-error'><\/span><\/div><\/div><\/div><\/div><div id='rm-note-1063' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-divider-1069' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1069'><hr class=\"rmform-divider hr\" width=\"100%\" size=\"8\" align=\"center\" ><span class='rmform-error-message' id='rmform-divider_1069-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-htmlh-1191' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1191'><h1 class=\"rmform-field-type-heading rmform-control \" >Information for the teacher<\/h1><span class='rmform-error-message' id='rmform-htmlh_1191-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-checkbox-1209' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1209'><span class=\"rmform-label\" > Is there a family history of any of the following areas of difficulty: Please Check All That Apply<span class='rmform-req-symbol'>*<\/span><\/span><div class='rmform-field-horizontal-row'><label class='rmform-check' for='checkbox_1209_0'><input name=\"Checkbox_1209[]\" class=\"rmform-control checkbox_1209 \" aria-describedby=\"rm-note-1209\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1209_0\" id=\"checkbox_1209_0\" value=\"None\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1209_0'>None<\/span><\/label><label class='rmform-check' for='checkbox_1209_1'><input name=\"Checkbox_1209[]\" class=\"rmform-control checkbox_1209 \" aria-describedby=\"rm-note-1209\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1209_1\" id=\"checkbox_1209_1\" value=\"Spatial Awareness\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1209_1'>Spatial Awareness<\/span><\/label><label class='rmform-check' for='checkbox_1209_2'><input name=\"Checkbox_1209[]\" class=\"rmform-control checkbox_1209 \" aria-describedby=\"rm-note-1209\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1209_2\" id=\"checkbox_1209_2\" value=\"Color Confusion\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1209_2'>Color Confusion<\/span><\/label><label class='rmform-check' for='checkbox_1209_3'><input name=\"Checkbox_1209[]\" class=\"rmform-control checkbox_1209 \" aria-describedby=\"rm-note-1209\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1209_3\" id=\"checkbox_1209_3\" value=\"Auditory Processing\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1209_3'>Auditory Processing<\/span><\/label><label class='rmform-check' for='checkbox_4'><input name=\"Checkbox_1209[]\" class=\"rmform-control checkbox_1209\" value=\"\" aria-describedby=\"rm-note-1209\" aria-labelledby=\"label_id_Checkbox_1209\" type=\"checkbox\" id=\"Checkbox_1209_other\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" ><span class='rmform-label rmform-radio-check' id=\"label_id_1209_4\" for=\"checkbox_1209_3\"  >Other<\/span><\/label><\/div><input name=\"Checkbox_1209_other_input\" class=\"rmform-control checkbox_1209\" aria-describedby=\"rm-note-1209\" aria-labelledby=\"label_id_Checkbox_1209\" type=\"text\" id=\"Checkbox_1209_other_input\" style=\"display:none;\" disabled  ><span class='rmform-error-message' id='rmform-checkbox_1209-error'><\/span><div id='rm-note-1209' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-checkbox-1210' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1210'><span class=\"rmform-label\" > Please identify if the STUDENT has any of the following areas of potential difficulty: Please Check All That Apply<span class='rmform-req-symbol'>*<\/span><\/span><div class='rmform-field-horizontal-row'><label class='rmform-check' for='checkbox_1210_0'><input name=\"Checkbox_1210[]\" class=\"rmform-control checkbox_1210 \" aria-describedby=\"rm-note-1210\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1210_0\" id=\"checkbox_1210_0\" value=\"None\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1210_0'>None<\/span><\/label><label class='rmform-check' for='checkbox_1210_1'><input name=\"Checkbox_1210[]\" class=\"rmform-control checkbox_1210 \" aria-describedby=\"rm-note-1210\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1210_1\" id=\"checkbox_1210_1\" value=\"Spatial Awareness\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1210_1'>Spatial Awareness<\/span><\/label><label class='rmform-check' for='checkbox_1210_2'><input name=\"Checkbox_1210[]\" class=\"rmform-control checkbox_1210 \" aria-describedby=\"rm-note-1210\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1210_2\" id=\"checkbox_1210_2\" value=\"Color Confusion\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1210_2'>Color Confusion<\/span><\/label><label class='rmform-check' for='checkbox_1210_3'><input name=\"Checkbox_1210[]\" class=\"rmform-control checkbox_1210 \" aria-describedby=\"rm-note-1210\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1210_3\" id=\"checkbox_1210_3\" value=\"Auditory Processing\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1210_3'>Auditory Processing<\/span><\/label><label class='rmform-check' for='checkbox_4'><input name=\"Checkbox_1210[]\" class=\"rmform-control checkbox_1210\" value=\"\" aria-describedby=\"rm-note-1210\" aria-labelledby=\"label_id_Checkbox_1210\" type=\"checkbox\" id=\"Checkbox_1210_other\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" ><span class='rmform-label rmform-radio-check' id=\"label_id_1210_4\" for=\"checkbox_1210_3\"  >Other<\/span><\/label><\/div><input name=\"Checkbox_1210_other_input\" class=\"rmform-control checkbox_1210\" aria-describedby=\"rm-note-1210\" aria-labelledby=\"label_id_Checkbox_1210\" type=\"text\" id=\"Checkbox_1210_other_input\" style=\"display:none;\" disabled  ><span class='rmform-error-message' id='rmform-checkbox_1210-error'><\/span><div id='rm-note-1210' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-checkbox-1068' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1068'><span class=\"rmform-label\" > Has your child ever been tested for or is currently receiving any of the following: Please Check All That Apply<span class='rmform-req-symbol'>*<\/span><\/span><div class='rmform-field-horizontal-row'><label class='rmform-check' for='checkbox_1068_0'><input name=\"Checkbox_1068[]\" class=\"rmform-control checkbox_1068 \" aria-describedby=\"rm-note-1068\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1068_0\" id=\"checkbox_1068_0\" value=\"None\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1068_0'>None<\/span><\/label><label class='rmform-check' for='checkbox_1068_1'><input name=\"Checkbox_1068[]\" class=\"rmform-control checkbox_1068 \" aria-describedby=\"rm-note-1068\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1068_1\" id=\"checkbox_1068_1\" value=\"Title I\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1068_1'>Title I<\/span><\/label><label class='rmform-check' for='checkbox_1068_2'><input name=\"Checkbox_1068[]\" class=\"rmform-control checkbox_1068 \" aria-describedby=\"rm-note-1068\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1068_2\" id=\"checkbox_1068_2\" value=\"LD\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1068_2'>LD<\/span><\/label><label class='rmform-check' for='checkbox_1068_3'><input name=\"Checkbox_1068[]\" class=\"rmform-control checkbox_1068 \" aria-describedby=\"rm-note-1068\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1068_3\" id=\"checkbox_1068_3\" value=\"Speech\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1068_3'>Speech<\/span><\/label><label class='rmform-check' for='checkbox_1068_4'><input name=\"Checkbox_1068[]\" class=\"rmform-control checkbox_1068 \" aria-describedby=\"rm-note-1068\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1068_4\" id=\"checkbox_1068_4\" value=\"IEP\/IPS\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1068_4'>IEP\/IPS<\/span><\/label><label class='rmform-check' for='checkbox_1068_5'><input name=\"Checkbox_1068[]\" class=\"rmform-control checkbox_1068 \" aria-describedby=\"rm-note-1068\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1068_5\" id=\"checkbox_1068_5\" value=\"Gifted\/Honors\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1068_5'>Gifted\/Honors<\/span><\/label><\/div><span class='rmform-error-message' id='rmform-checkbox_1068-error'><\/span><div id='rm-note-1068' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-checkbox-1193' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1193'><span class=\"rmform-label\" > My child needs help: Please Check All That Apply<span class='rmform-req-symbol'>*<\/span><\/span><div class='rmform-field-horizontal-row'><label class='rmform-check' for='checkbox_1193_0'><input name=\"Checkbox_1193[]\" class=\"rmform-control checkbox_1193 \" aria-describedby=\"rm-note-1193\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1193_0\" id=\"checkbox_1193_0\" value=\"None\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1193_0'>None<\/span><\/label><label class='rmform-check' for='checkbox_1193_1'><input name=\"Checkbox_1193[]\" class=\"rmform-control checkbox_1193 \" aria-describedby=\"rm-note-1193\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1193_1\" id=\"checkbox_1193_1\" value=\"Dressing\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1193_1'>Dressing<\/span><\/label><label class='rmform-check' for='checkbox_1193_2'><input name=\"Checkbox_1193[]\" class=\"rmform-control checkbox_1193 \" aria-describedby=\"rm-note-1193\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1193_2\" id=\"checkbox_1193_2\" value=\"Eating\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1193_2'>Eating<\/span><\/label><label class='rmform-check' for='checkbox_1193_3'><input name=\"Checkbox_1193[]\" class=\"rmform-control checkbox_1193 \" aria-describedby=\"rm-note-1193\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1193_3\" id=\"checkbox_1193_3\" value=\"Toileting\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1193_3'>Toileting<\/span><\/label><label class='rmform-check' for='checkbox_1193_4'><input name=\"Checkbox_1193[]\" class=\"rmform-control checkbox_1193 \" aria-describedby=\"rm-note-1193\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1193_4\" id=\"checkbox_1193_4\" value=\"Communicating\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1193_4'>Communicating<\/span><\/label><label class='rmform-check' for='checkbox_5'><input name=\"Checkbox_1193[]\" class=\"rmform-control checkbox_1193\" value=\"\" aria-describedby=\"rm-note-1193\" aria-labelledby=\"label_id_Checkbox_1193\" type=\"checkbox\" id=\"Checkbox_1193_other\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" ><span class='rmform-label rmform-radio-check' id=\"label_id_1193_5\" for=\"checkbox_1193_4\"  >Other<\/span><\/label><\/div><input name=\"Checkbox_1193_other_input\" class=\"rmform-control checkbox_1193\" aria-describedby=\"rm-note-1193\" aria-labelledby=\"label_id_Checkbox_1193\" type=\"text\" id=\"Checkbox_1193_other_input\" style=\"display:none;\" disabled  ><span class='rmform-error-message' id='rmform-checkbox_1193-error'><\/span><div id='rm-note-1193' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-radio-1066' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1066'><span class=\"rmform-label\" > In the past 12 months, has the student had disciplinary difficulties?<span class='rmform-req-symbol'>*<\/span><\/span><div class='rmform-field-horizontal-row'><label class='rmform-check' for='Radio_1066_0'><input name=\"Radio_1066\" class=\"rmform-control radio_1066 \" aria-describedby=\"rm-note-1066\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1066_0\" value=\"Yes\" aria-labelledby=\"label_id_Radio_1066_0\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1066_0\"  >Yes<\/span><\/label><label class='rmform-check' for='Radio_1066_1'><input name=\"Radio_1066\" class=\"rmform-control radio_1066 \" aria-describedby=\"rm-note-1066\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1066_1\" value=\"No\" aria-labelledby=\"label_id_Radio_1066_1\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1066_1\"  >No<\/span><\/label><\/div><span class='rmform-error-message' id='rmform-radio_1066-error'><\/span><div id='rm-note-1066' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textarea-1067' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1067'><label for=\"input_id_Textarea_1067\" id=\"label_id_Textarea_1067\" class=\"rmform-label\" > If so, please explain<\/label><textarea name=\"Textarea_1067\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1067\" minlength=\"\" maxlength=\"\" cols=\"\" rows=\"\" id=\"input_id_Textarea_1067\" placeholder=\"\" data-cond-option=\"Radio_1066\" data-cond-value=\"Yes\" data-cond-operator=\"==\" data-cond-action=\"show\"  ><\/textarea><span class='rmform-error-message' id='rmform-textarea_1067-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1195' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1195'><label for=\"input_id_Textbox_1195\" id=\"label_id_Textbox_1195\" class=\"rmform-label\" >  List any fears or phobias your child has:<\/label><input type=\"text\" name=\"Textbox_1195\" class=\"rmform-control \" aria-describedby=\"rm-note-1195\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1195\" aria-labelledby=\"label_id_Textbox_1195\" placeholder=\"\"  ><span class='rmform-error-message' id='rmform-textbox_1195-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-divider-1208' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1208'><hr class=\"rmform-divider hr\" width=\"100%\" size=\"8\" align=\"center\" ><span class='rmform-error-message' id='rmform-divider_1208-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-htmlh-1070' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1070'><h1 class=\"rmform-field-type-heading rmform-control \" >Ethnicity\/Race<\/h1><span class='rmform-error-message' id='rmform-htmlh_1070-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-radio-1071' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1071'><span class=\"rmform-label\" > Is the student Hispanic or Latino?<span class='rmform-req-symbol'>*<\/span><\/span><div class='rmform-field-horizontal-row'><label class='rmform-check' for='Radio_1071_0'><input name=\"Radio_1071\" class=\"rmform-control radio_1071 \" aria-describedby=\"rm-note-1071\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1071_0\" value=\"Yes\" aria-labelledby=\"label_id_Radio_1071_0\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1071_0\"  >Yes<\/span><\/label><label class='rmform-check' for='Radio_1071_1'><input name=\"Radio_1071\" class=\"rmform-control radio_1071 \" aria-describedby=\"rm-note-1071\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1071_1\" value=\"No\" aria-labelledby=\"label_id_Radio_1071_1\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1071_1\"  >No<\/span><\/label><\/div><span class='rmform-error-message' id='rmform-radio_1071-error'><\/span><div id='rm-note-1071' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-checkbox-1072' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1072'><span class=\"rmform-label\" > Race<\/span><div class='rmform-field-horizontal-row'><label class='rmform-check' for='checkbox_1072_0'><input name=\"Checkbox_1072[]\" class=\"rmform-control checkbox_1072 \" aria-describedby=\"rm-note-1072\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" aria-labelledby=\"label_id_Checkbox_1072_0\" id=\"checkbox_1072_0\" value=\"American Indian or Alaskan Native\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1072_0'>American Indian or Alaskan Native<\/span><\/label><label class='rmform-check' for='checkbox_1072_1'><input name=\"Checkbox_1072[]\" class=\"rmform-control checkbox_1072 \" aria-describedby=\"rm-note-1072\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" aria-labelledby=\"label_id_Checkbox_1072_1\" id=\"checkbox_1072_1\" value=\"Asian\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1072_1'>Asian<\/span><\/label><label class='rmform-check' for='checkbox_1072_2'><input name=\"Checkbox_1072[]\" class=\"rmform-control checkbox_1072 \" aria-describedby=\"rm-note-1072\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" aria-labelledby=\"label_id_Checkbox_1072_2\" id=\"checkbox_1072_2\" value=\"Black or African American\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1072_2'>Black or African American<\/span><\/label><label class='rmform-check' for='checkbox_1072_3'><input name=\"Checkbox_1072[]\" class=\"rmform-control checkbox_1072 \" aria-describedby=\"rm-note-1072\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" aria-labelledby=\"label_id_Checkbox_1072_3\" id=\"checkbox_1072_3\" value=\"Native Hawaiian or other Pacific Islander\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1072_3'>Native Hawaiian or other Pacific Islander<\/span><\/label><label class='rmform-check' for='checkbox_1072_4'><input name=\"Checkbox_1072[]\" class=\"rmform-control checkbox_1072 \" aria-describedby=\"rm-note-1072\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" aria-labelledby=\"label_id_Checkbox_1072_4\" id=\"checkbox_1072_4\" value=\"Caucasian\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1072_4'>Caucasian<\/span><\/label><label class='rmform-check' for='checkbox_1072_5'><input name=\"Checkbox_1072[]\" class=\"rmform-control checkbox_1072 \" aria-describedby=\"rm-note-1072\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" aria-labelledby=\"label_id_Checkbox_1072_5\" id=\"checkbox_1072_5\" value=\"Other or Refuse to Identify\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1072_5'>Other or Refuse to Identify<\/span><\/label><\/div><span class='rmform-error-message' id='rmform-checkbox_1072-error'><\/span><div id='rm-note-1072' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1073' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1073'><label for=\"input_id_Textbox_1073\" id=\"label_id_Textbox_1073\" class=\"rmform-label\" >  Primary Language Spoken at Home<\/label><input type=\"text\" name=\"Textbox_1073\" class=\"rmform-control \" aria-describedby=\"rm-note-1073\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1073\" aria-labelledby=\"label_id_Textbox_1073\" placeholder=\"\"  ><span class='rmform-error-message' id='rmform-textbox_1073-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-divider-1074' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1074'><hr class=\"rmform-divider hr\" width=\"100%\" size=\"8\" align=\"center\" ><span class='rmform-error-message' id='rmform-divider_1074-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-htmlh-1075' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1075'><h1 class=\"rmform-field-type-heading rmform-control \" >Medical<\/h1><span class='rmform-error-message' id='rmform-htmlh_1075-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-radio-1076' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1076'><span class=\"rmform-label\" > Allergies<span class='rmform-req-symbol'>*<\/span><\/span><div class='rmform-field-horizontal-row'><label class='rmform-check' for='Radio_1076_0'><input name=\"Radio_1076\" class=\"rmform-control radio_1076 \" aria-describedby=\"rm-note-1076\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1076_0\" value=\"Yes\" aria-labelledby=\"label_id_Radio_1076_0\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1076_0\"  >Yes<\/span><\/label><label class='rmform-check' for='Radio_1076_1'><input name=\"Radio_1076\" class=\"rmform-control radio_1076 \" aria-describedby=\"rm-note-1076\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1076_1\" value=\"No\" aria-labelledby=\"label_id_Radio_1076_1\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1076_1\"  >No<\/span><\/label><\/div><span class='rmform-error-message' id='rmform-radio_1076-error'><\/span><div id='rm-note-1076' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1077' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1077'><label for=\"input_id_Textbox_1077\" id=\"label_id_Textbox_1077\" class=\"rmform-label\" >  List allergies here<\/label><input type=\"text\" name=\"Textbox_1077\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1077\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1077\" aria-labelledby=\"label_id_Textbox_1077\" placeholder=\"\" data-cond-option=\"Radio_1076\" data-cond-value=\"Yes\" data-cond-operator=\"==\" data-cond-action=\"show\"  ><span class='rmform-error-message' id='rmform-textbox_1077-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-radio-1078' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1078'><span class=\"rmform-label\" > Glasses<span class='rmform-req-symbol'>*<\/span><\/span><div class='rmform-field-horizontal-row'><label class='rmform-check' for='Radio_1078_0'><input name=\"Radio_1078\" class=\"rmform-control radio_1078 \" aria-describedby=\"rm-note-1078\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1078_0\" value=\"Yes\" aria-labelledby=\"label_id_Radio_1078_0\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1078_0\"  >Yes<\/span><\/label><label class='rmform-check' for='Radio_1078_1'><input name=\"Radio_1078\" class=\"rmform-control radio_1078 \" aria-describedby=\"rm-note-1078\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1078_1\" value=\"No\" aria-labelledby=\"label_id_Radio_1078_1\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1078_1\"  >No<\/span><\/label><\/div><span class='rmform-error-message' id='rmform-radio_1078-error'><\/span><div id='rm-note-1078' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-radio-1079' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1079'><span class=\"rmform-label\" > Hearing Aids\/Accommodations<span class='rmform-req-symbol'>*<\/span><\/span><div class='rmform-field-horizontal-row'><label class='rmform-check' for='Radio_1079_0'><input name=\"Radio_1079\" class=\"rmform-control radio_1079 \" aria-describedby=\"rm-note-1079\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1079_0\" value=\"Yes\" aria-labelledby=\"label_id_Radio_1079_0\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1079_0\"  >Yes<\/span><\/label><label class='rmform-check' for='Radio_1079_1'><input name=\"Radio_1079\" class=\"rmform-control radio_1079 \" aria-describedby=\"rm-note-1079\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1079_1\" value=\"No\" aria-labelledby=\"label_id_Radio_1079_1\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1079_1\"  >No<\/span><\/label><\/div><span class='rmform-error-message' id='rmform-radio_1079-error'><\/span><div id='rm-note-1079' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1080' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1080'><label for=\"input_id_Textbox_1080\" id=\"label_id_Textbox_1080\" class=\"rmform-label\" >  List Accommodations here<\/label><input type=\"text\" name=\"Textbox_1080\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1080\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1080\" aria-labelledby=\"label_id_Textbox_1080\" placeholder=\"\" data-cond-option=\"Radio_1079\" data-cond-value=\"Yes\" data-cond-operator=\"==\" data-cond-action=\"show\"  ><span class='rmform-error-message' id='rmform-textbox_1080-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-file-1081' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1081'><label for=\"input_id_File_1081\" id=\"label_id_File_1081\" class=\"rmform-label\" > Birth Certificate<span class='rmform-req-symbol'>*<\/span><\/label><input type=\"file\" name=\"File_1081[]\" class=\"rmform-control \" aria-describedby=\"rm-note-1081\" id=\"input_id_File_1081\" aria-labelledby=\"label_id_File_1081\" data-fieldtype=\"File\" multiple required aria-required=\"true\"  ><span class='rmform-error-message' id='rmform-file_1081-error'><\/span><div id='rm-note-1081' class='rmform-note' style='display: none;'>Please Upload your students Birth Certificate here<\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-file-1082' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1082'><label for=\"input_id_File_1082\" id=\"label_id_File_1082\" class=\"rmform-label\" > Please Upload Immunization Records or Certificate of Immunization<span class='rmform-req-symbol'>*<\/span><\/label><input type=\"file\" name=\"File_1082[]\" class=\"rmform-control \" aria-describedby=\"rm-note-1082\" id=\"input_id_File_1082\" aria-labelledby=\"label_id_File_1082\" data-fieldtype=\"File\" multiple required aria-required=\"true\"  ><span class='rmform-error-message' id='rmform-file_1082-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-link-1083' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1083'><a class=\"rmform-control \" href=\"https:\/\/docs.google.com\/document\/d\/1DTiDFBTjfVsaSIM8KIGukTPlBylV1i0MTdxcNhnMpVY\/edit?usp=sharing\" target=\"_blank\" >  CERTIFICATE OF IMMUNIZATION<\/a><span class='rmform-error-message' id='rmform-link_1083-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-divider-1084' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1084'><hr class=\"rmform-divider hr\" width=\"100%\" size=\"8\" align=\"center\" ><span class='rmform-error-message' id='rmform-divider_1084-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-htmlh-1137' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1137'><h1 class=\"rmform-field-type-heading rmform-control \" >Daycare<\/h1><span class='rmform-error-message' id='rmform-htmlh_1137-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-radio-1138' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1138'><span class=\"rmform-label\" > Does your child currently attend daycare\/preschool?<\/span><div class='rmform-field-horizontal-row'><label class='rmform-check' for='Radio_1138_0'><input name=\"Radio_1138\" class=\"rmform-control radio_1138 \" aria-describedby=\"rm-note-1138\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" id=\"Radio_1138_0\" value=\"Yes\" aria-labelledby=\"label_id_Radio_1138_0\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1138_0\"  >Yes<\/span><\/label><label class='rmform-check' for='Radio_1138_1'><input name=\"Radio_1138\" class=\"rmform-control radio_1138 \" aria-describedby=\"rm-note-1138\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" id=\"Radio_1138_1\" value=\"No\" aria-labelledby=\"label_id_Radio_1138_1\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1138_1\"  >No<\/span><\/label><\/div><span class='rmform-error-message' id='rmform-radio_1138-error'><\/span><div id='rm-note-1138' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1139' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1139'><label for=\"input_id_Textbox_1139\" id=\"label_id_Textbox_1139\" class=\"rmform-label\" >  Daycare\/Preschool Name<\/label><input type=\"text\" name=\"Textbox_1139\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1139\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1139\" aria-labelledby=\"label_id_Textbox_1139\" placeholder=\"\" data-cond-option=\"Radio_1138\" data-cond-value=\"Yes\" data-cond-operator=\"==\" data-cond-action=\"show\"  ><span class='rmform-error-message' id='rmform-textbox_1139-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1140' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1140'><label for=\"input_id_Textbox_1140\" id=\"label_id_Textbox_1140\" class=\"rmform-label\" >  Daycare\/Preschool Caregiver's Name<\/label><input type=\"text\" name=\"Textbox_1140\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1140\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1140\" aria-labelledby=\"label_id_Textbox_1140\" placeholder=\"\" data-cond-option=\"Radio_1138\" data-cond-value=\"Yes\" data-cond-operator=\"==\" data-cond-action=\"show\"  ><span class='rmform-error-message' id='rmform-textbox_1140-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-phone-1141' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1141'><label for=\"input_id_Phone_1141\" id=\"label_id_Phone_1141\" class=\"rmform-label\" > Daycare\/Preschool Daytime Phone<\/label><input type=\"tel\" name=\"Phone_1141\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1141\" minlength=\"\" maxlength=\"\" id=\"input_id_Phone_1141\" aria-labelledby=\"label_id_Phone_1141\" placeholder=\"\" data-cond-option=\"Radio_1138\" data-cond-value=\"Yes\" data-cond-operator=\"==\" data-cond-action=\"show\"  ><span class='rmform-error-message' id='rmform-phone_1141-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-divider-1096' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1096'><hr class=\"rmform-divider \" width=\"100%\" size=\"8\" align=\"center\" ><span class='rmform-error-message' id='rmform-divider_1096-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-htmlh-1097' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1097'><h1 class=\"rmform-field-type-heading rmform-control \" >Family Information<\/h1><span class='rmform-error-message' id='rmform-htmlh_1097-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-radio-1098' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1098'><span class=\"rmform-label\" > Marital Status<span class='rmform-req-symbol'>*<\/span><\/span><div class='rmform-field-horizontal-row'><label class='rmform-check' for='Radio_1098_0'><input name=\"Radio_1098\" class=\"rmform-control radio_1098 \" aria-describedby=\"rm-note-1098\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1098_0\" value=\"Single\" aria-labelledby=\"label_id_Radio_1098_0\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1098_0\"  >Single<\/span><\/label><label class='rmform-check' for='Radio_1098_1'><input name=\"Radio_1098\" class=\"rmform-control radio_1098 \" aria-describedby=\"rm-note-1098\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1098_1\" value=\"Married\" aria-labelledby=\"label_id_Radio_1098_1\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1098_1\"  >Married<\/span><\/label><label class='rmform-check' for='Radio_1098_2'><input name=\"Radio_1098\" class=\"rmform-control radio_1098 \" aria-describedby=\"rm-note-1098\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1098_2\" value=\"Divorced\" aria-labelledby=\"label_id_Radio_1098_2\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1098_2\"  >Divorced<\/span><\/label><label class='rmform-check' for='Radio_1098_3'><input name=\"Radio_1098\" class=\"rmform-control radio_1098 \" aria-describedby=\"rm-note-1098\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1098_3\" value=\"Separated\" aria-labelledby=\"label_id_Radio_1098_3\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1098_3\"  >Separated<\/span><\/label><\/div><span class='rmform-error-message' id='rmform-radio_1098-error'><\/span><div id='rm-note-1098' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-checkbox-1099' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1099'><span class=\"rmform-label\" > Who Does Student Live With? (Select All that Apply)<span class='rmform-req-symbol'>*<\/span><\/span><div class='rmform-field-horizontal-row'><label class='rmform-check' for='checkbox_1099_0'><input name=\"Checkbox_1099[]\" class=\"rmform-control checkbox_1099 \" aria-describedby=\"rm-note-1099\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1099_0\" id=\"checkbox_1099_0\" value=\"Mother\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1099_0'>Mother<\/span><\/label><label class='rmform-check' for='checkbox_1099_1'><input name=\"Checkbox_1099[]\" class=\"rmform-control checkbox_1099 \" aria-describedby=\"rm-note-1099\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1099_1\" id=\"checkbox_1099_1\" value=\"Father\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1099_1'>Father<\/span><\/label><label class='rmform-check' for='checkbox_1099_2'><input name=\"Checkbox_1099[]\" class=\"rmform-control checkbox_1099 \" aria-describedby=\"rm-note-1099\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1099_2\" id=\"checkbox_1099_2\" value=\"Step-Father\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1099_2'>Step-Father<\/span><\/label><label class='rmform-check' for='checkbox_1099_3'><input name=\"Checkbox_1099[]\" class=\"rmform-control checkbox_1099 \" aria-describedby=\"rm-note-1099\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1099_3\" id=\"checkbox_1099_3\" value=\"Step-Mother\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1099_3'>Step-Mother<\/span><\/label><label class='rmform-check' for='checkbox_1099_4'><input name=\"Checkbox_1099[]\" class=\"rmform-control checkbox_1099 \" aria-describedby=\"rm-note-1099\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1099_4\" id=\"checkbox_1099_4\" value=\"Guardian\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1099_4'>Guardian<\/span><\/label><\/div><span class='rmform-error-message' id='rmform-checkbox_1099-error'><\/span><div id='rm-note-1099' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-radio-1100' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1100'><span class=\"rmform-label\" > Are there restrictions on who can pick up your child from school?<span class='rmform-req-symbol'>*<\/span><\/span><div class='rmform-field-horizontal-row'><label class='rmform-check' for='Radio_1100_0'><input name=\"Radio_1100\" class=\"rmform-control radio_1100 \" aria-describedby=\"rm-note-1100\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1100_0\" value=\"Yes\" aria-labelledby=\"label_id_Radio_1100_0\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1100_0\"  >Yes<\/span><\/label><label class='rmform-check' for='Radio_1100_1'><input name=\"Radio_1100\" class=\"rmform-control radio_1100 \" aria-describedby=\"rm-note-1100\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1100_1\" value=\"No\" aria-labelledby=\"label_id_Radio_1100_1\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1100_1\"  >No<\/span><\/label><\/div><span class='rmform-error-message' id='rmform-radio_1100-error'><\/span><div id='rm-note-1100' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1101' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1101'><label for=\"input_id_Textbox_1101\" id=\"label_id_Textbox_1101\" class=\"rmform-label\" >  If so, then whom?<\/label><input type=\"text\" name=\"Textbox_1101\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1101\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1101\" aria-labelledby=\"label_id_Textbox_1101\" placeholder=\"\" data-cond-option=\"Radio_1100\" data-cond-value=\"Yes\" data-cond-operator=\"==\" data-cond-action=\"show\"  ><span class='rmform-error-message' id='rmform-textbox_1101-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-radio-1102' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1102'><span class=\"rmform-label\" > Is there a current court-ordered parenting, visitation, or safety plan?<span class='rmform-req-symbol'>*<\/span><\/span><div class='rmform-field-horizontal-row'><label class='rmform-check' for='Radio_1102_0'><input name=\"Radio_1102\" class=\"rmform-control radio_1102 \" aria-describedby=\"rm-note-1102\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1102_0\" value=\"Yes\" aria-labelledby=\"label_id_Radio_1102_0\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1102_0\"  >Yes<\/span><\/label><label class='rmform-check' for='Radio_1102_1'><input name=\"Radio_1102\" class=\"rmform-control radio_1102 \" aria-describedby=\"rm-note-1102\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1102_1\" value=\"No\" aria-labelledby=\"label_id_Radio_1102_1\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1102_1\"  >No<\/span><\/label><\/div><span class='rmform-error-message' id='rmform-radio_1102-error'><\/span><div id='rm-note-1102' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textarea-1103' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1103'><label for=\"input_id_Textarea_1103\" id=\"label_id_Textarea_1103\" class=\"rmform-label\" > Please explain<\/label><textarea name=\"Textarea_1103\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1103\" minlength=\"\" maxlength=\"\" cols=\"\" rows=\"\" id=\"input_id_Textarea_1103\" placeholder=\"\" data-cond-option=\"Radio_1102\" data-cond-value=\"Yes\" data-cond-operator=\"==\" data-cond-action=\"show\"  ><\/textarea><span class='rmform-error-message' id='rmform-textarea_1103-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-file-1104' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1104'><label for=\"input_id_File_1104\" id=\"label_id_File_1104\" class=\"rmform-label\" > Upload court documents below.<\/label><input type=\"file\" name=\"File_1104[]\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1104\" id=\"input_id_File_1104\" aria-labelledby=\"label_id_File_1104\" data-fieldtype=\"File\" multiple data-cond-option=\"Radio_1102\" data-cond-value=\"Yes\" data-cond-operator=\"==\" data-cond-action=\"show\"  ><span class='rmform-error-message' id='rmform-file_1104-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-divider-1105' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1105'><hr class=\"rmform-divider hr\" width=\"100%\" size=\"8\" align=\"center\" ><span class='rmform-error-message' id='rmform-divider_1105-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-htmlh-1106' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1106'><h1 class=\"rmform-field-type-heading rmform-control \" >Father<\/h1><span class='rmform-error-message' id='rmform-htmlh_1106-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1107' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1107'><label for=\"input_id_Textbox_1107\" id=\"label_id_Textbox_1107\" class=\"rmform-label\" >  Father's First and Last Name<span class='rmform-req-symbol'>*<\/span><\/label><input type=\"text\" name=\"Textbox_1107\" class=\"rmform-control \" aria-describedby=\"rm-note-1107\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1107\" aria-labelledby=\"label_id_Textbox_1107\" placeholder=\"\" required aria-required=\"true\"  ><span class='rmform-error-message' id='rmform-textbox_1107-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-address-1108' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1108'><label class=\"rmform-label\" >  Father's Address<\/label><div class='rmform-row'><div class='rmform-row-field-wrap'><div class='rmform-col rmform-col-12'><div class='rmform-field'><input type=\"text\" class=\"rmform-control\" aria-describedby=\"rm-note-1108\" id=\"input_id_address1_1108\" name=\"Address_1108[address1]\" aria-labelledby=\"label_id_address1_1108\" value=\"\" required aria-required=\"true\"  ><label for='input_id_address1_1108' id='label_id_address1_1108' class='rmform-label rmform-label-address'> Address Line 1<span class='rmform-req-symbol'>*<\/span><\/label><span class='rmform-error-message' id='rmform-address_1108address1-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'><div class='rmform-col rmform-col-12'><div class='rmform-field'><input type=\"text\" class=\"rmform-control\" aria-describedby=\"rm-note-1108\" id=\"input_id_address2_label_1108\" name=\"Address_1108[address2]\" aria-labelledby=\"label_id_address2_label_1108\" value=\"\" ><label for='input_id_address2_label_1108' id='label_id_address2_label_1108' class='rmform-label rmform-label-address'> Address Line 2<\/label><span class='rmform-error-message' id='rmform-address_1108address2-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'><div class='rmform-col rmform-col-6'><div class='rmform-field'><input type=\"text\" class=\"rmform-control\" aria-describedby=\"rm-note-1108\" id=\"input_id_city_label_1108\" name=\"Address_1108[city]\" aria-labelledby=\"label_id_city_label_1108\" value=\"\" required aria-required=\"true\"  ><label for='input_id_city_label_1108' id='label_id_city_label_1108' class='rmform-label rmform-label-address'> City<span class='rmform-req-symbol'>*<\/span><\/label><span class='rmform-error-message' id='rmform-address_1108city-error'><\/span><\/div><\/div><div class='rmform-col rmform-col-6'><div class='rmform-field'><select type=\"text\" class=\"rmform-control\" aria-describedby=\"rm-note-1108\" id=\"input_id_state_label_1108\" name=\"Address_1108[state]\" aria-labelledby=\"label_id_state_label_1108\" value=\"\" required aria-required=\"true\"  ><option value=''>--Select State--<\/option><option value='Alabama'>Alabama<\/option><option value='Alaska'>Alaska<\/option><option value='Arizona'>Arizona<\/option><option value='Arkansas'>Arkansas<\/option><option value='Armed Forces America'>Armed Forces America<\/option><option value='Armed Forces Europe'>Armed Forces Europe<\/option><option value='Armed Forces Pacific'>Armed Forces Pacific<\/option><option value='California'>California<\/option><option value='Colorado'>Colorado<\/option><option value='Connecticut'>Connecticut<\/option><option value='Delaware'>Delaware<\/option><option value='District Of Columbia'>District Of Columbia<\/option><option value='Florida'>Florida<\/option><option value='Georgia'>Georgia<\/option><option value='Hawaii'>Hawaii<\/option><option value='Idaho'>Idaho<\/option><option value='Illinois'>Illinois<\/option><option value='Indiana'>Indiana<\/option><option value='Iowa'>Iowa<\/option><option value='Kansas'>Kansas<\/option><option value='Kentucky'>Kentucky<\/option><option value='Louisiana'>Louisiana<\/option><option value='Maine'>Maine<\/option><option value='Maryland'>Maryland<\/option><option value='Massachusetts'>Massachusetts<\/option><option value='Michigan'>Michigan<\/option><option value='Minnesota'>Minnesota<\/option><option value='Mississippi'>Mississippi<\/option><option value='Missouri'>Missouri<\/option><option value='Montana'>Montana<\/option><option value='Nebraska'>Nebraska<\/option><option value='Nevada'>Nevada<\/option><option value='New Hampshire'>New Hampshire<\/option><option value='New Jersey'>New Jersey<\/option><option value='New Mexico'>New Mexico<\/option><option value='New York'>New York<\/option><option value='North Carolina'>North Carolina<\/option><option value='North Dakota'>North Dakota<\/option><option value='Ohio'>Ohio<\/option><option value='Oklahoma'>Oklahoma<\/option><option value='Oregon'>Oregon<\/option><option value='Pennsylvania'>Pennsylvania<\/option><option value='Rhode Island'>Rhode Island<\/option><option value='South Carolina'>South Carolina<\/option><option value='South Dakota'>South Dakota<\/option><option value='Tennessee'>Tennessee<\/option><option value='Texas'>Texas<\/option><option value='Utah'>Utah<\/option><option value='Vermont'>Vermont<\/option><option value='Virginia'>Virginia<\/option><option value='Washington'>Washington<\/option><option value='West Virginia'>West Virginia<\/option><option value='Wisconsin'>Wisconsin<\/option><option value='Wyoming'>Wyoming<\/option><\/select><label for='input_id_state_label_1108' id='label_id_state_label_1108' class='rmform-label rmform-label-address'>State or Region<span class='rmform-req-symbol'>*<\/span><\/label><span class='rmform-error-message' id='rmform-address_1108state-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'><div class='rmform-col rmform-col-6'><div class='rmform-field'><select type=\"text\" class=\"rmform-control\" aria-describedby=\"rm-note-1108\" id=\"input_id_country_label_1108\" name=\"Address_1108[country]\" aria-labelledby=\"label_id_country_label_1108\" value=\"\" onchange=\"update_state_dropdown(1108)\" required aria-required=\"true\"  ><option value='US'>United States<\/option><option value='Canada'>Canada<\/option><\/select><label for='input_id_country_label_1108' id='label_id_country_label_1108' class='rmform-label rmform-label-address'> Country<span class='rmform-req-symbol'>*<\/span><\/label><span class='rmform-error-message' id='rmform-address_1108country-error'><\/span><\/div><\/div><div class='rmform-col rmform-col-6'><div class='rmform-field'><input type=\"text\" class=\"rmform-control\" aria-describedby=\"rm-note-1108\" id=\"input_id_zip_label_1108\" name=\"Address_1108[zip]\" aria-labelledby=\"label_id_zip_label_1108\" value=\"\" required aria-required=\"true\"  ><label for='input_id_zip_label_1108' id='label_id_zip_label_1108' class='rmform-label rmform-label-address'> Zip<span class='rmform-req-symbol'>*<\/span><\/label><span class='rmform-error-message' id='rmform-address_1108zip-error'><\/span><\/div><\/div><\/div><\/div><div id='rm-note-1108' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-phone-1109' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1109'><label for=\"input_id_Phone_1109\" id=\"label_id_Phone_1109\" class=\"rmform-label\" > Father's Home Phone<span class='rmform-req-symbol'>*<\/span><\/label><input type=\"tel\" name=\"Phone_1109\" class=\"rmform-control \" aria-describedby=\"rm-note-1109\" minlength=\"\" maxlength=\"\" id=\"input_id_Phone_1109\" aria-labelledby=\"label_id_Phone_1109\" placeholder=\"\" required aria-required=\"true\"  ><span class='rmform-error-message' id='rmform-phone_1109-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-email-1110' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1110'><label for=\"input_id_Email_1110\" id=\"label_id_Email_1110\" class=\"rmform-label\"  >  Father's Email<\/label><input type=\"email\" name=\"Email_1110\" class=\"rmform-control \" aria-describedby=\"rm-note-1110\" id=\"input_id_Email_1110\" data-fieldtype=\"Email\" aria-labelledby=\"label_id_Email_1110\" value=\"\" placeholder=\"\" data-primary=\"0\"  ><span class='rmform-error-message' id='rmform-email_1110-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1111' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1111'><label for=\"input_id_Textbox_1111\" id=\"label_id_Textbox_1111\" class=\"rmform-label\" >  Father's Employer<span class='rmform-req-symbol'>*<\/span><\/label><input type=\"text\" name=\"Textbox_1111\" class=\"rmform-control \" aria-describedby=\"rm-note-1111\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1111\" aria-labelledby=\"label_id_Textbox_1111\" placeholder=\"\" required aria-required=\"true\"  ><span class='rmform-error-message' id='rmform-textbox_1111-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-phone-1112' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1112'><label for=\"input_id_Phone_1112\" id=\"label_id_Phone_1112\" class=\"rmform-label\" > Father's Day Phone<span class='rmform-req-symbol'>*<\/span><\/label><input type=\"tel\" name=\"Phone_1112\" class=\"rmform-control \" aria-describedby=\"rm-note-1112\" minlength=\"\" maxlength=\"\" id=\"input_id_Phone_1112\" aria-labelledby=\"label_id_Phone_1112\" placeholder=\"\" required aria-required=\"true\"  ><span class='rmform-error-message' id='rmform-phone_1112-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-divider-1113' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1113'><hr class=\"rmform-divider \" width=\"100%\" size=\"8\" align=\"center\" ><span class='rmform-error-message' id='rmform-divider_1113-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-htmlh-1114' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1114'><h1 class=\"rmform-field-type-heading rmform-control \" >Mother<\/h1><span class='rmform-error-message' id='rmform-htmlh_1114-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1115' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1115'><label for=\"input_id_Textbox_1115\" id=\"label_id_Textbox_1115\" class=\"rmform-label\" >  Mother's First and Last Name<span class='rmform-req-symbol'>*<\/span><\/label><input type=\"text\" name=\"Textbox_1115\" class=\"rmform-control \" aria-describedby=\"rm-note-1115\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1115\" aria-labelledby=\"label_id_Textbox_1115\" placeholder=\"\" required aria-required=\"true\"  ><span class='rmform-error-message' id='rmform-textbox_1115-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-address-1116' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1116'><label class=\"rmform-label\" >  Mother's Address<\/label><div class='rmform-row'><div class='rmform-row-field-wrap'><div class='rmform-col rmform-col-12'><div class='rmform-field'><input type=\"text\" class=\"rmform-control\" aria-describedby=\"rm-note-1116\" id=\"input_id_address1_1116\" name=\"Address_1116[address1]\" aria-labelledby=\"label_id_address1_1116\" value=\"\"  ><label for='input_id_address1_1116' id='label_id_address1_1116' class='rmform-label rmform-label-address'> Address Line 1<\/label><span class='rmform-error-message' id='rmform-address_1116address1-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'><div class='rmform-col rmform-col-12'><div class='rmform-field'><input type=\"text\" class=\"rmform-control\" aria-describedby=\"rm-note-1116\" id=\"input_id_address2_label_1116\" name=\"Address_1116[address2]\" aria-labelledby=\"label_id_address2_label_1116\" value=\"\" ><label for='input_id_address2_label_1116' id='label_id_address2_label_1116' class='rmform-label rmform-label-address'> Address Line 2<\/label><span class='rmform-error-message' id='rmform-address_1116address2-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'><div class='rmform-col rmform-col-6'><div class='rmform-field'><input type=\"text\" class=\"rmform-control\" aria-describedby=\"rm-note-1116\" id=\"input_id_city_label_1116\" name=\"Address_1116[city]\" aria-labelledby=\"label_id_city_label_1116\" value=\"\"  ><label for='input_id_city_label_1116' id='label_id_city_label_1116' class='rmform-label rmform-label-address'> City<\/label><span class='rmform-error-message' id='rmform-address_1116city-error'><\/span><\/div><\/div><div class='rmform-col rmform-col-6'><div class='rmform-field'><select type=\"text\" class=\"rmform-control\" aria-describedby=\"rm-note-1116\" id=\"input_id_state_label_1116\" name=\"Address_1116[state]\" aria-labelledby=\"label_id_state_label_1116\" value=\"\"  ><option value=''>--Select State--<\/option><option value='Alabama'>Alabama<\/option><option value='Alaska'>Alaska<\/option><option value='Arizona'>Arizona<\/option><option value='Arkansas'>Arkansas<\/option><option value='Armed Forces America'>Armed Forces America<\/option><option value='Armed Forces Europe'>Armed Forces Europe<\/option><option value='Armed Forces Pacific'>Armed Forces Pacific<\/option><option value='California'>California<\/option><option value='Colorado'>Colorado<\/option><option value='Connecticut'>Connecticut<\/option><option value='Delaware'>Delaware<\/option><option value='District Of Columbia'>District Of Columbia<\/option><option value='Florida'>Florida<\/option><option value='Georgia'>Georgia<\/option><option value='Hawaii'>Hawaii<\/option><option value='Idaho'>Idaho<\/option><option value='Illinois'>Illinois<\/option><option value='Indiana'>Indiana<\/option><option value='Iowa'>Iowa<\/option><option value='Kansas'>Kansas<\/option><option value='Kentucky'>Kentucky<\/option><option value='Louisiana'>Louisiana<\/option><option value='Maine'>Maine<\/option><option value='Maryland'>Maryland<\/option><option value='Massachusetts'>Massachusetts<\/option><option value='Michigan'>Michigan<\/option><option value='Minnesota'>Minnesota<\/option><option value='Mississippi'>Mississippi<\/option><option value='Missouri'>Missouri<\/option><option value='Montana'>Montana<\/option><option value='Nebraska'>Nebraska<\/option><option value='Nevada'>Nevada<\/option><option value='New Hampshire'>New Hampshire<\/option><option value='New Jersey'>New Jersey<\/option><option value='New Mexico'>New Mexico<\/option><option value='New York'>New York<\/option><option value='North Carolina'>North Carolina<\/option><option value='North Dakota'>North Dakota<\/option><option value='Ohio'>Ohio<\/option><option value='Oklahoma'>Oklahoma<\/option><option value='Oregon'>Oregon<\/option><option value='Pennsylvania'>Pennsylvania<\/option><option value='Rhode Island'>Rhode Island<\/option><option value='South Carolina'>South Carolina<\/option><option value='South Dakota'>South Dakota<\/option><option value='Tennessee'>Tennessee<\/option><option value='Texas'>Texas<\/option><option value='Utah'>Utah<\/option><option value='Vermont'>Vermont<\/option><option value='Virginia'>Virginia<\/option><option value='Washington'>Washington<\/option><option value='West Virginia'>West Virginia<\/option><option value='Wisconsin'>Wisconsin<\/option><option value='Wyoming'>Wyoming<\/option><\/select><label for='input_id_state_label_1116' id='label_id_state_label_1116' class='rmform-label rmform-label-address'>State or Region<\/label><span class='rmform-error-message' id='rmform-address_1116state-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'><div class='rmform-col rmform-col-6'><div class='rmform-field'><select type=\"text\" class=\"rmform-control\" aria-describedby=\"rm-note-1116\" id=\"input_id_country_label_1116\" name=\"Address_1116[country]\" aria-labelledby=\"label_id_country_label_1116\" value=\"\" onchange=\"update_state_dropdown(1116)\"  ><option value='US'>United States<\/option><option value='Canada'>Canada<\/option><\/select><label for='input_id_country_label_1116' id='label_id_country_label_1116' class='rmform-label rmform-label-address'> Country<\/label><span class='rmform-error-message' id='rmform-address_1116country-error'><\/span><\/div><\/div><div class='rmform-col rmform-col-6'><div class='rmform-field'><input type=\"text\" class=\"rmform-control\" aria-describedby=\"rm-note-1116\" id=\"input_id_zip_label_1116\" name=\"Address_1116[zip]\" aria-labelledby=\"label_id_zip_label_1116\" value=\"\"  ><label for='input_id_zip_label_1116' id='label_id_zip_label_1116' class='rmform-label rmform-label-address'> Zip<\/label><span class='rmform-error-message' id='rmform-address_1116zip-error'><\/span><\/div><\/div><\/div><\/div><div id='rm-note-1116' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-phone-1117' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1117'><label for=\"input_id_Phone_1117\" id=\"label_id_Phone_1117\" class=\"rmform-label\" > Mother's Home Phone<span class='rmform-req-symbol'>*<\/span><\/label><input type=\"tel\" name=\"Phone_1117\" class=\"rmform-control \" aria-describedby=\"rm-note-1117\" minlength=\"\" maxlength=\"\" id=\"input_id_Phone_1117\" aria-labelledby=\"label_id_Phone_1117\" placeholder=\"\" required aria-required=\"true\"  ><span class='rmform-error-message' id='rmform-phone_1117-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-email-1118' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1118'><label for=\"input_id_Email_1118\" id=\"label_id_Email_1118\" class=\"rmform-label\"  >  Mother's Email<\/label><input type=\"email\" name=\"Email_1118\" class=\"rmform-control \" aria-describedby=\"rm-note-1118\" id=\"input_id_Email_1118\" data-fieldtype=\"Email\" aria-labelledby=\"label_id_Email_1118\" value=\"\" placeholder=\"\" data-primary=\"0\"  ><span class='rmform-error-message' id='rmform-email_1118-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1119' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1119'><label for=\"input_id_Textbox_1119\" id=\"label_id_Textbox_1119\" class=\"rmform-label\" >  Mother's Employer<span class='rmform-req-symbol'>*<\/span><\/label><input type=\"text\" name=\"Textbox_1119\" class=\"rmform-control \" aria-describedby=\"rm-note-1119\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1119\" aria-labelledby=\"label_id_Textbox_1119\" placeholder=\"\" required aria-required=\"true\"  ><span class='rmform-error-message' id='rmform-textbox_1119-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-phone-1120' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1120'><label for=\"input_id_Phone_1120\" id=\"label_id_Phone_1120\" class=\"rmform-label\" > Mother's Day Phone<\/label><input type=\"tel\" name=\"Phone_1120\" class=\"rmform-control \" aria-describedby=\"rm-note-1120\" minlength=\"\" maxlength=\"\" id=\"input_id_Phone_1120\" aria-labelledby=\"label_id_Phone_1120\" placeholder=\"\"  ><span class='rmform-error-message' id='rmform-phone_1120-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-divider-1121' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1121'><hr class=\"rmform-divider \" width=\"100%\" size=\"8\" align=\"center\" ><span class='rmform-error-message' id='rmform-divider_1121-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-htmlh-1122' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1122'><h1 class=\"rmform-field-type-heading rmform-control  data-conditional-revamp\" data-cond-option=\"Checkbox_1099[]|Checkbox_1099[]\" data-cond-value=\"Step-Mother|Step-Father\" data-cond-operator=\"==|==\" data-cond-action=\"show\" data-cond-comb=\"OR\" >Step-Parent<\/h1><span class='rmform-error-message' id='rmform-htmlh_1122-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1123' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1123'><label for=\"input_id_Textbox_1123\" id=\"label_id_Textbox_1123\" class=\"rmform-label\" >  Step-Parent First and Last Name<\/label><input type=\"text\" name=\"Textbox_1123\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1123\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1123\" aria-labelledby=\"label_id_Textbox_1123\" placeholder=\"\" data-cond-option=\"Checkbox_1099[]|Checkbox_1099[]\" data-cond-value=\"Step-Father|Step-Mother\" data-cond-operator=\"==|==\" data-cond-action=\"show\" data-cond-comb=\"OR\"  ><span class='rmform-error-message' id='rmform-textbox_1123-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-address-1124' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1124'><label class=\"rmform-label\" >  Step-Parent Address<\/label><div class='rmform-row'><div class='rmform-row-field-wrap'><div class='rmform-col rmform-col-12'><div class='rmform-field'><input type=\"text\" class=\"rmform-control data-conditional-revamp\" aria-describedby=\"rm-note-1124\" data-cond-option=\"Checkbox_1099[]|Checkbox_1099[]\" data-cond-value=\"Step-Mother|Step-Father\" data-cond-operator=\"==|==\" data-cond-action=\"show\" data-cond-comb=\"OR\" id=\"input_id_address1_1124\" name=\"Address_1124[address1]\" aria-labelledby=\"label_id_address1_1124\" value=\"\"  ><label for='input_id_address1_1124' id='label_id_address1_1124' class='rmform-label rmform-label-address'> Address Line 1<\/label><span class='rmform-error-message' id='rmform-address_1124address1-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'><div class='rmform-col rmform-col-12'><div class='rmform-field'><input type=\"text\" class=\"rmform-control data-conditional-revamp\" aria-describedby=\"rm-note-1124\" data-cond-option=\"Checkbox_1099[]|Checkbox_1099[]\" data-cond-value=\"Step-Mother|Step-Father\" data-cond-operator=\"==|==\" data-cond-action=\"show\" data-cond-comb=\"OR\" id=\"input_id_address2_label_1124\" name=\"Address_1124[address2]\" aria-labelledby=\"label_id_address2_label_1124\" value=\"\" ><label for='input_id_address2_label_1124' id='label_id_address2_label_1124' class='rmform-label rmform-label-address'> Address Line 2<\/label><span class='rmform-error-message' id='rmform-address_1124address2-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'><div class='rmform-col rmform-col-6'><div class='rmform-field'><input type=\"text\" class=\"rmform-control data-conditional-revamp\" aria-describedby=\"rm-note-1124\" data-cond-option=\"Checkbox_1099[]|Checkbox_1099[]\" data-cond-value=\"Step-Mother|Step-Father\" data-cond-operator=\"==|==\" data-cond-action=\"show\" data-cond-comb=\"OR\" id=\"input_id_city_label_1124\" name=\"Address_1124[city]\" aria-labelledby=\"label_id_city_label_1124\" value=\"\"  ><label for='input_id_city_label_1124' id='label_id_city_label_1124' class='rmform-label rmform-label-address'> City<\/label><span class='rmform-error-message' id='rmform-address_1124city-error'><\/span><\/div><\/div><div class='rmform-col rmform-col-6'><div class='rmform-field'><select type=\"text\" class=\"rmform-control data-conditional-revamp\" aria-describedby=\"rm-note-1124\" data-cond-option=\"Checkbox_1099[]|Checkbox_1099[]\" data-cond-value=\"Step-Mother|Step-Father\" data-cond-operator=\"==|==\" data-cond-action=\"show\" data-cond-comb=\"OR\" id=\"input_id_state_label_1124\" name=\"Address_1124[state]\" aria-labelledby=\"label_id_state_label_1124\" value=\"\"  ><option value=''>--Select State--<\/option><option value='Alabama'>Alabama<\/option><option value='Alaska'>Alaska<\/option><option value='Arizona'>Arizona<\/option><option value='Arkansas'>Arkansas<\/option><option value='Armed Forces America'>Armed Forces America<\/option><option value='Armed Forces Europe'>Armed Forces Europe<\/option><option value='Armed Forces Pacific'>Armed Forces Pacific<\/option><option value='California'>California<\/option><option value='Colorado'>Colorado<\/option><option value='Connecticut'>Connecticut<\/option><option value='Delaware'>Delaware<\/option><option value='District Of Columbia'>District Of Columbia<\/option><option value='Florida'>Florida<\/option><option value='Georgia'>Georgia<\/option><option value='Hawaii'>Hawaii<\/option><option value='Idaho'>Idaho<\/option><option value='Illinois'>Illinois<\/option><option value='Indiana'>Indiana<\/option><option value='Iowa'>Iowa<\/option><option value='Kansas'>Kansas<\/option><option value='Kentucky'>Kentucky<\/option><option value='Louisiana'>Louisiana<\/option><option value='Maine'>Maine<\/option><option value='Maryland'>Maryland<\/option><option value='Massachusetts'>Massachusetts<\/option><option value='Michigan'>Michigan<\/option><option value='Minnesota'>Minnesota<\/option><option value='Mississippi'>Mississippi<\/option><option value='Missouri'>Missouri<\/option><option value='Montana'>Montana<\/option><option value='Nebraska'>Nebraska<\/option><option value='Nevada'>Nevada<\/option><option value='New Hampshire'>New Hampshire<\/option><option value='New Jersey'>New Jersey<\/option><option value='New Mexico'>New Mexico<\/option><option value='New York'>New York<\/option><option value='North Carolina'>North Carolina<\/option><option value='North Dakota'>North Dakota<\/option><option value='Ohio'>Ohio<\/option><option value='Oklahoma'>Oklahoma<\/option><option value='Oregon'>Oregon<\/option><option value='Pennsylvania'>Pennsylvania<\/option><option value='Rhode Island'>Rhode Island<\/option><option value='South Carolina'>South Carolina<\/option><option value='South Dakota'>South Dakota<\/option><option value='Tennessee'>Tennessee<\/option><option value='Texas'>Texas<\/option><option value='Utah'>Utah<\/option><option value='Vermont'>Vermont<\/option><option value='Virginia'>Virginia<\/option><option value='Washington'>Washington<\/option><option value='West Virginia'>West Virginia<\/option><option value='Wisconsin'>Wisconsin<\/option><option value='Wyoming'>Wyoming<\/option><\/select><label for='input_id_state_label_1124' id='label_id_state_label_1124' class='rmform-label rmform-label-address'>State or Region<\/label><span class='rmform-error-message' id='rmform-address_1124state-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'><div class='rmform-col rmform-col-6'><div class='rmform-field'><select type=\"text\" class=\"rmform-control data-conditional-revamp\" aria-describedby=\"rm-note-1124\" data-cond-option=\"Checkbox_1099[]|Checkbox_1099[]\" data-cond-value=\"Step-Mother|Step-Father\" data-cond-operator=\"==|==\" data-cond-action=\"show\" data-cond-comb=\"OR\" id=\"input_id_country_label_1124\" name=\"Address_1124[country]\" aria-labelledby=\"label_id_country_label_1124\" value=\"\" onchange=\"update_state_dropdown(1124)\"  ><option value='US'>United States<\/option><option value='Canada'>Canada<\/option><\/select><label for='input_id_country_label_1124' id='label_id_country_label_1124' class='rmform-label rmform-label-address'> Country<\/label><span class='rmform-error-message' id='rmform-address_1124country-error'><\/span><\/div><\/div><div class='rmform-col rmform-col-6'><div class='rmform-field'><input type=\"text\" class=\"rmform-control data-conditional-revamp\" aria-describedby=\"rm-note-1124\" data-cond-option=\"Checkbox_1099[]|Checkbox_1099[]\" data-cond-value=\"Step-Mother|Step-Father\" data-cond-operator=\"==|==\" data-cond-action=\"show\" data-cond-comb=\"OR\" id=\"input_id_zip_label_1124\" name=\"Address_1124[zip]\" aria-labelledby=\"label_id_zip_label_1124\" value=\"\"  ><label for='input_id_zip_label_1124' id='label_id_zip_label_1124' class='rmform-label rmform-label-address'> Zip<\/label><span class='rmform-error-message' id='rmform-address_1124zip-error'><\/span><\/div><\/div><\/div><\/div><div id='rm-note-1124' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-phone-1125' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1125'><label for=\"input_id_Phone_1125\" id=\"label_id_Phone_1125\" class=\"rmform-label\" > Step-Parent Phone<\/label><input type=\"tel\" name=\"Phone_1125\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1125\" minlength=\"\" maxlength=\"\" id=\"input_id_Phone_1125\" aria-labelledby=\"label_id_Phone_1125\" placeholder=\"\" data-cond-option=\"Checkbox_1099[]|Checkbox_1099[]\" data-cond-value=\"Step-Mother|Step-Father\" data-cond-operator=\"==|==\" data-cond-action=\"show\" data-cond-comb=\"OR\"  ><span class='rmform-error-message' id='rmform-phone_1125-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-email-1126' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1126'><label for=\"input_id_Email_1126\" id=\"label_id_Email_1126\" class=\"rmform-label\"  >  Step Parent Email<\/label><input type=\"email\" name=\"Email_1126\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1126\" id=\"input_id_Email_1126\" data-fieldtype=\"Email\" aria-labelledby=\"label_id_Email_1126\" value=\"\" placeholder=\"\" data-primary=\"0\" data-cond-option=\"Checkbox_1099[]|Checkbox_1099[]\" data-cond-value=\"Step-Father|Step-Mother\" data-cond-operator=\"==|==\" data-cond-action=\"show\" data-cond-comb=\"OR\"  ><span class='rmform-error-message' id='rmform-email_1126-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1127' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1127'><label for=\"input_id_Textbox_1127\" id=\"label_id_Textbox_1127\" class=\"rmform-label\" >  Step-Parent Employer<\/label><input type=\"text\" name=\"Textbox_1127\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1127\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1127\" aria-labelledby=\"label_id_Textbox_1127\" placeholder=\"\" data-cond-option=\"Checkbox_1099[]|Checkbox_1099[]\" data-cond-value=\"Step-Mother|Step-Father\" data-cond-operator=\"==|==\" data-cond-action=\"show\" data-cond-comb=\"OR\"  ><span class='rmform-error-message' id='rmform-textbox_1127-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-phone-1128' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1128'><label for=\"input_id_Phone_1128\" id=\"label_id_Phone_1128\" class=\"rmform-label\" > Step-Parent Work Phone<\/label><input type=\"tel\" name=\"Phone_1128\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1128\" minlength=\"\" maxlength=\"\" id=\"input_id_Phone_1128\" aria-labelledby=\"label_id_Phone_1128\" placeholder=\"\" data-cond-option=\"Checkbox_1099[]|Checkbox_1099[]\" data-cond-value=\"Step-Mother|Step-Father\" data-cond-operator=\"==|==\" data-cond-action=\"show\" data-cond-comb=\"OR\"  ><span class='rmform-error-message' id='rmform-phone_1128-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-htmlh-1129' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1129'><h1 class=\"rmform-field-type-heading rmform-control  data-conditional-revamp\" data-cond-option=\"Checkbox_1099[]\" data-cond-value=\"Guardian\" data-cond-operator=\"==\" data-cond-action=\"show\" >Guardian<\/h1><span class='rmform-error-message' id='rmform-htmlh_1129-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1130' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1130'><label for=\"input_id_Textbox_1130\" id=\"label_id_Textbox_1130\" class=\"rmform-label\" >  Guardian's First and Last Name<\/label><input type=\"text\" name=\"Textbox_1130\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1130\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1130\" aria-labelledby=\"label_id_Textbox_1130\" placeholder=\"\" data-cond-option=\"Checkbox_1099[]\" data-cond-value=\"Guardian\" data-cond-operator=\"==\" data-cond-action=\"show\"  ><span class='rmform-error-message' id='rmform-textbox_1130-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-address-1131' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1131'><label class=\"rmform-label\" >  Guardian Address<\/label><div class='rmform-row'><div class='rmform-row-field-wrap'><div class='rmform-col rmform-col-12'><div class='rmform-field'><input type=\"text\" class=\"rmform-control data-conditional-revamp\" aria-describedby=\"rm-note-1131\" data-cond-option=\"Checkbox_1099[]\" data-cond-value=\"Guardian\" data-cond-operator=\"==\" data-cond-action=\"show\" id=\"input_id_address1_1131\" name=\"Address_1131[address1]\" aria-labelledby=\"label_id_address1_1131\" value=\"\"  ><label for='input_id_address1_1131' id='label_id_address1_1131' class='rmform-label rmform-label-address'> Address Line 1<\/label><span class='rmform-error-message' id='rmform-address_1131address1-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'><div class='rmform-col rmform-col-12'><div class='rmform-field'><input type=\"text\" class=\"rmform-control data-conditional-revamp\" aria-describedby=\"rm-note-1131\" data-cond-option=\"Checkbox_1099[]\" data-cond-value=\"Guardian\" data-cond-operator=\"==\" data-cond-action=\"show\" id=\"input_id_address2_label_1131\" name=\"Address_1131[address2]\" aria-labelledby=\"label_id_address2_label_1131\" value=\"\" ><label for='input_id_address2_label_1131' id='label_id_address2_label_1131' class='rmform-label rmform-label-address'> Address Line 2<\/label><span class='rmform-error-message' id='rmform-address_1131address2-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'><div class='rmform-col rmform-col-6'><div class='rmform-field'><input type=\"text\" class=\"rmform-control data-conditional-revamp\" aria-describedby=\"rm-note-1131\" data-cond-option=\"Checkbox_1099[]\" data-cond-value=\"Guardian\" data-cond-operator=\"==\" data-cond-action=\"show\" id=\"input_id_city_label_1131\" name=\"Address_1131[city]\" aria-labelledby=\"label_id_city_label_1131\" value=\"\"  ><label for='input_id_city_label_1131' id='label_id_city_label_1131' class='rmform-label rmform-label-address'> City<\/label><span class='rmform-error-message' id='rmform-address_1131city-error'><\/span><\/div><\/div><div class='rmform-col rmform-col-6'><div class='rmform-field'><select type=\"text\" class=\"rmform-control data-conditional-revamp\" aria-describedby=\"rm-note-1131\" data-cond-option=\"Checkbox_1099[]\" data-cond-value=\"Guardian\" data-cond-operator=\"==\" data-cond-action=\"show\" id=\"input_id_state_label_1131\" name=\"Address_1131[state]\" aria-labelledby=\"label_id_state_label_1131\" value=\"\"  ><option value=''>--Select State--<\/option><option value='Alabama'>Alabama<\/option><option value='Alaska'>Alaska<\/option><option value='Arizona'>Arizona<\/option><option value='Arkansas'>Arkansas<\/option><option value='Armed Forces America'>Armed Forces America<\/option><option value='Armed Forces Europe'>Armed Forces Europe<\/option><option value='Armed Forces Pacific'>Armed Forces Pacific<\/option><option value='California'>California<\/option><option value='Colorado'>Colorado<\/option><option value='Connecticut'>Connecticut<\/option><option value='Delaware'>Delaware<\/option><option value='District Of Columbia'>District Of Columbia<\/option><option value='Florida'>Florida<\/option><option value='Georgia'>Georgia<\/option><option value='Hawaii'>Hawaii<\/option><option value='Idaho'>Idaho<\/option><option value='Illinois'>Illinois<\/option><option value='Indiana'>Indiana<\/option><option value='Iowa'>Iowa<\/option><option value='Kansas'>Kansas<\/option><option value='Kentucky'>Kentucky<\/option><option value='Louisiana'>Louisiana<\/option><option value='Maine'>Maine<\/option><option value='Maryland'>Maryland<\/option><option value='Massachusetts'>Massachusetts<\/option><option value='Michigan'>Michigan<\/option><option value='Minnesota'>Minnesota<\/option><option value='Mississippi'>Mississippi<\/option><option value='Missouri'>Missouri<\/option><option value='Montana'>Montana<\/option><option value='Nebraska'>Nebraska<\/option><option value='Nevada'>Nevada<\/option><option value='New Hampshire'>New Hampshire<\/option><option value='New Jersey'>New Jersey<\/option><option value='New Mexico'>New Mexico<\/option><option value='New York'>New York<\/option><option value='North Carolina'>North Carolina<\/option><option value='North Dakota'>North Dakota<\/option><option value='Ohio'>Ohio<\/option><option value='Oklahoma'>Oklahoma<\/option><option value='Oregon'>Oregon<\/option><option value='Pennsylvania'>Pennsylvania<\/option><option value='Rhode Island'>Rhode Island<\/option><option value='South Carolina'>South Carolina<\/option><option value='South Dakota'>South Dakota<\/option><option value='Tennessee'>Tennessee<\/option><option value='Texas'>Texas<\/option><option value='Utah'>Utah<\/option><option value='Vermont'>Vermont<\/option><option value='Virginia'>Virginia<\/option><option value='Washington'>Washington<\/option><option value='West Virginia'>West Virginia<\/option><option value='Wisconsin'>Wisconsin<\/option><option value='Wyoming'>Wyoming<\/option><\/select><label for='input_id_state_label_1131' id='label_id_state_label_1131' class='rmform-label rmform-label-address'>State or Region<\/label><span class='rmform-error-message' id='rmform-address_1131state-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'><div class='rmform-col rmform-col-6'><div class='rmform-field'><select type=\"text\" class=\"rmform-control data-conditional-revamp\" aria-describedby=\"rm-note-1131\" data-cond-option=\"Checkbox_1099[]\" data-cond-value=\"Guardian\" data-cond-operator=\"==\" data-cond-action=\"show\" id=\"input_id_country_label_1131\" name=\"Address_1131[country]\" aria-labelledby=\"label_id_country_label_1131\" value=\"\" onchange=\"update_state_dropdown(1131)\"  ><option value='US'>United States<\/option><option value='Canada'>Canada<\/option><\/select><label for='input_id_country_label_1131' id='label_id_country_label_1131' class='rmform-label rmform-label-address'> Country<\/label><span class='rmform-error-message' id='rmform-address_1131country-error'><\/span><\/div><\/div><div class='rmform-col rmform-col-6'><div class='rmform-field'><input type=\"text\" class=\"rmform-control data-conditional-revamp\" aria-describedby=\"rm-note-1131\" data-cond-option=\"Checkbox_1099[]\" data-cond-value=\"Guardian\" data-cond-operator=\"==\" data-cond-action=\"show\" id=\"input_id_zip_label_1131\" name=\"Address_1131[zip]\" aria-labelledby=\"label_id_zip_label_1131\" value=\"\"  ><label for='input_id_zip_label_1131' id='label_id_zip_label_1131' class='rmform-label rmform-label-address'> Zip<\/label><span class='rmform-error-message' id='rmform-address_1131zip-error'><\/span><\/div><\/div><\/div><\/div><div id='rm-note-1131' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-phone-1132' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1132'><label for=\"input_id_Phone_1132\" id=\"label_id_Phone_1132\" class=\"rmform-label\" > Guardian Phone<\/label><input type=\"tel\" name=\"Phone_1132\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1132\" minlength=\"\" maxlength=\"\" id=\"input_id_Phone_1132\" aria-labelledby=\"label_id_Phone_1132\" placeholder=\"\" data-cond-option=\"Checkbox_1099[]\" data-cond-value=\"Guardian\" data-cond-operator=\"==\" data-cond-action=\"show\"  ><span class='rmform-error-message' id='rmform-phone_1132-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-email-1133' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1133'><label for=\"input_id_Email_1133\" id=\"label_id_Email_1133\" class=\"rmform-label\"  >  Guardian Email<\/label><input type=\"email\" name=\"Email_1133\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1133\" id=\"input_id_Email_1133\" data-fieldtype=\"Email\" aria-labelledby=\"label_id_Email_1133\" value=\"\" placeholder=\"\" data-primary=\"0\" data-cond-option=\"Checkbox_1099[]\" data-cond-value=\"Guardian\" data-cond-operator=\"==\" data-cond-action=\"show\"  ><span class='rmform-error-message' id='rmform-email_1133-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1134' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1134'><label for=\"input_id_Textbox_1134\" id=\"label_id_Textbox_1134\" class=\"rmform-label\" >  Guardian Employer<\/label><input type=\"text\" name=\"Textbox_1134\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1134\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1134\" aria-labelledby=\"label_id_Textbox_1134\" placeholder=\"\" data-cond-option=\"Checkbox_1099[]\" data-cond-value=\"Guardian\" data-cond-operator=\"==\" data-cond-action=\"show\"  ><span class='rmform-error-message' id='rmform-textbox_1134-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-phone-1135' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1135'><label for=\"input_id_Phone_1135\" id=\"label_id_Phone_1135\" class=\"rmform-label\" > Guardian Work Phone<\/label><input type=\"tel\" name=\"Phone_1135\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1135\" minlength=\"\" maxlength=\"\" id=\"input_id_Phone_1135\" aria-labelledby=\"label_id_Phone_1135\" placeholder=\"\" data-cond-option=\"Checkbox_1099[]\" data-cond-value=\"Guardian\" data-cond-operator=\"==\" data-cond-action=\"show\"  ><span class='rmform-error-message' id='rmform-phone_1135-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-divider-1142' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1142'><hr class=\"rmform-divider \" width=\"100%\" size=\"8\" align=\"center\" ><span class='rmform-error-message' id='rmform-divider_1142-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-htmlh-1211' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1211'><h1 class=\"rmform-field-type-heading rmform-control \" >Emergency Contacts<\/h1><span class='rmform-error-message' id='rmform-htmlh_1211-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-subheading'>(other than parent)<\/div><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1145' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1145'><label for=\"input_id_Textbox_1145\" id=\"label_id_Textbox_1145\" class=\"rmform-label\" >  Emergency Contact 1<span class='rmform-req-symbol'>*<\/span><\/label><input type=\"text\" name=\"Textbox_1145\" class=\"rmform-control \" aria-describedby=\"rm-note-1145\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1145\" aria-labelledby=\"label_id_Textbox_1145\" placeholder=\"\" required aria-required=\"true\"  ><span class='rmform-error-message' id='rmform-textbox_1145-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-select-1146' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1146'><label for=\"input_id_Select_1146\" id=\"label_id_Select_1146\" class=\"rmform-label\" > Relationship to Student<span class='rmform-req-symbol'>*<\/span><\/label><select name=\"Select_1146\" class=\"rmform-control select_1146 \" aria-describedby=\"rm-note-1146\" id=\"input_id_Select_1146\" aria-labelledby=\"label_id_Select_1146\" required aria-required=\"true\"  ><option value=''>Select an option<\/option><option value='Mother'>Mother<\/option><option value='Father'>Father<\/option><option value='Grandmother'>Grandmother<\/option><option value='Grandfather'>Grandfather<\/option><option value='Step Mother'>Step Mother<\/option><option value='Step Father'>Step Father<\/option><option value='Aunt'>Aunt<\/option><option value='Uncle'>Uncle<\/option><option value='Sister'>Sister<\/option><option value='Brother'>Brother<\/option><option value='Friend'>Friend<\/option><option value='Neighbor'>Neighbor<\/option><option value='Other'>Other<\/option><\/select><span class='rmform-error-message' id='rmform-select_1146-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1147' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1147'><label for=\"input_id_Textbox_1147\" id=\"label_id_Textbox_1147\" class=\"rmform-label\" >  If Other, please list relationship to student<span class='rmform-req-symbol'>*<\/span><\/label><input type=\"text\" name=\"Textbox_1147\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1147\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1147\" aria-labelledby=\"label_id_Textbox_1147\" placeholder=\"\" data-cond-option=\"Select_1146\" data-cond-value=\"Other\" data-cond-operator=\"==\" data-cond-action=\"show\" required aria-required=\"true\"  ><span class='rmform-error-message' id='rmform-textbox_1147-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-phone-1148' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1148'><label for=\"input_id_Phone_1148\" id=\"label_id_Phone_1148\" class=\"rmform-label\" > Phone Number<span class='rmform-req-symbol'>*<\/span><\/label><input type=\"tel\" name=\"Phone_1148\" class=\"rmform-control \" aria-describedby=\"rm-note-1148\" minlength=\"\" maxlength=\"\" id=\"input_id_Phone_1148\" aria-labelledby=\"label_id_Phone_1148\" placeholder=\"\" required aria-required=\"true\"  ><span class='rmform-error-message' id='rmform-phone_1148-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1149' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1149'><label for=\"input_id_Textbox_1149\" id=\"label_id_Textbox_1149\" class=\"rmform-label\" >  Emergency Contact 2<span class='rmform-req-symbol'>*<\/span><\/label><input type=\"text\" name=\"Textbox_1149\" class=\"rmform-control \" aria-describedby=\"rm-note-1149\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1149\" aria-labelledby=\"label_id_Textbox_1149\" placeholder=\"\" required aria-required=\"true\"  ><span class='rmform-error-message' id='rmform-textbox_1149-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-select-1150' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1150'><label for=\"input_id_Select_1150\" id=\"label_id_Select_1150\" class=\"rmform-label\" > Relationship to Student<span class='rmform-req-symbol'>*<\/span><\/label><select name=\"Select_1150\" class=\"rmform-control select_1150 \" aria-describedby=\"rm-note-1150\" id=\"input_id_Select_1150\" aria-labelledby=\"label_id_Select_1150\" required aria-required=\"true\"  ><option value=''>Select an option<\/option><option value='Mother'>Mother<\/option><option value='Father'>Father<\/option><option value='Grandmother'>Grandmother<\/option><option value='Grandfather'>Grandfather<\/option><option value='Step Mother'>Step Mother<\/option><option value='Step Father'>Step Father<\/option><option value='Aunt'>Aunt<\/option><option value='Uncle'>Uncle<\/option><option value='Sister'>Sister<\/option><option value='Brother'>Brother<\/option><option value='Friend'>Friend<\/option><option value='Neighbor'>Neighbor<\/option><option value='Other'>Other<\/option><\/select><span class='rmform-error-message' id='rmform-select_1150-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1151' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1151'><label for=\"input_id_Textbox_1151\" id=\"label_id_Textbox_1151\" class=\"rmform-label\" >  If Other, please list relationship to student<span class='rmform-req-symbol'>*<\/span><\/label><input type=\"text\" name=\"Textbox_1151\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1151\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1151\" aria-labelledby=\"label_id_Textbox_1151\" placeholder=\"\" data-cond-option=\"Select_1150\" data-cond-value=\"Other\" data-cond-operator=\"==\" data-cond-action=\"show\" required aria-required=\"true\"  ><span class='rmform-error-message' id='rmform-textbox_1151-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-phone-1152' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1152'><label for=\"input_id_Phone_1152\" id=\"label_id_Phone_1152\" class=\"rmform-label\" > Phone Number<span class='rmform-req-symbol'>*<\/span><\/label><input type=\"tel\" name=\"Phone_1152\" class=\"rmform-control \" aria-describedby=\"rm-note-1152\" minlength=\"\" maxlength=\"\" id=\"input_id_Phone_1152\" aria-labelledby=\"label_id_Phone_1152\" placeholder=\"\" required aria-required=\"true\"  ><span class='rmform-error-message' id='rmform-phone_1152-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-divider-1153' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1153'><hr class=\"rmform-divider hr\" width=\"100%\" size=\"8\" align=\"center\" ><span class='rmform-error-message' id='rmform-divider_1153-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-htmlh-1154' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1154'><h1 class=\"rmform-field-type-heading rmform-control \" >Discovering Williston Trinity Christian School<\/h1><span class='rmform-error-message' id='rmform-htmlh_1154-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-checkbox-1155' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1155'><span class=\"rmform-label\" > How or whom did you hear about Williston Trinity Christian School? Choose all that apply:<span class='rmform-req-symbol'>*<\/span><\/span><div class='rmform-field-horizontal-row'><label class='rmform-check' for='checkbox_1155_0'><input name=\"Checkbox_1155[]\" class=\"rmform-control checkbox_1155 \" aria-describedby=\"rm-note-1155\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1155_0\" id=\"checkbox_1155_0\" value=\"Social Media\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1155_0'>Social Media<\/span><\/label><label class='rmform-check' for='checkbox_1155_1'><input name=\"Checkbox_1155[]\" class=\"rmform-control checkbox_1155 \" aria-describedby=\"rm-note-1155\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1155_1\" id=\"checkbox_1155_1\" value=\"Radio\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1155_1'>Radio<\/span><\/label><label class='rmform-check' for='checkbox_1155_2'><input name=\"Checkbox_1155[]\" class=\"rmform-control checkbox_1155 \" aria-describedby=\"rm-note-1155\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1155_2\" id=\"checkbox_1155_2\" value=\"Newspaper\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1155_2'>Newspaper<\/span><\/label><label class='rmform-check' for='checkbox_1155_3'><input name=\"Checkbox_1155[]\" class=\"rmform-control checkbox_1155 \" aria-describedby=\"rm-note-1155\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1155_3\" id=\"checkbox_1155_3\" value=\"Community Event\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1155_3'>Community Event<\/span><\/label><label class='rmform-check' for='checkbox_1155_4'><input name=\"Checkbox_1155[]\" class=\"rmform-control checkbox_1155 \" aria-describedby=\"rm-note-1155\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1155_4\" id=\"checkbox_1155_4\" value=\"Recommended\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1155_4'>Recommended<\/span><\/label><label class='rmform-check' for='checkbox_1155_5'><input name=\"Checkbox_1155[]\" class=\"rmform-control checkbox_1155 \" aria-describedby=\"rm-note-1155\" type=\"checkbox\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" aria-labelledby=\"label_id_Checkbox_1155_5\" id=\"checkbox_1155_5\" value=\"Other\"  ><span class='rmform-label rmform-radio-check' id='label_id_Checkbox_1155_5'>Other<\/span><\/label><\/div><span class='rmform-error-message' id='rmform-checkbox_1155-error'><\/span><div id='rm-note-1155' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1156' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1156'><label for=\"input_id_Textbox_1156\" id=\"label_id_Textbox_1156\" class=\"rmform-label\" >  What event did you attend?<\/label><input type=\"text\" name=\"Textbox_1156\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1156\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1156\" aria-labelledby=\"label_id_Textbox_1156\" placeholder=\"\" data-cond-option=\"Checkbox_1155[]\" data-cond-value=\"Community Event\" data-cond-operator=\"==\" data-cond-action=\"show\"  ><span class='rmform-error-message' id='rmform-textbox_1156-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1157' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1157'><label for=\"input_id_Textbox_1157\" id=\"label_id_Textbox_1157\" class=\"rmform-label\" >  Who referred you to WTCS?<\/label><input type=\"text\" name=\"Textbox_1157\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1157\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1157\" aria-labelledby=\"label_id_Textbox_1157\" placeholder=\"\" data-cond-option=\"Checkbox_1155[]\" data-cond-value=\"Recommended\" data-cond-operator=\"==\" data-cond-action=\"show\"  ><span class='rmform-error-message' id='rmform-textbox_1157-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1158' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1158'><label for=\"input_id_Textbox_1158\" id=\"label_id_Textbox_1158\" class=\"rmform-label\" >  If Other, please explain.<\/label><input type=\"text\" name=\"Textbox_1158\" class=\"rmform-control  data-conditional-revamp\" aria-describedby=\"rm-note-1158\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1158\" aria-labelledby=\"label_id_Textbox_1158\" placeholder=\"\" data-cond-option=\"Checkbox_1155[]\" data-cond-value=\"Other\" data-cond-operator=\"==\" data-cond-action=\"show\"  ><span class='rmform-error-message' id='rmform-textbox_1158-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-divider-1159' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1159'><hr class=\"rmform-divider \" width=\"100%\" size=\"8\" align=\"center\" ><span class='rmform-error-message' id='rmform-divider_1159-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-htmlh-1160' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1160'><h1 class=\"rmform-field-type-heading rmform-control \" >Church Information<\/h1><span class='rmform-error-message' id='rmform-htmlh_1160-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-htmlp-1161' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1161'><p class=\"rmform-control \" >Students attending Williston Trinity Christian School are strongly encouraged to attend church regularly. Our purpose is to help Christian youth\r\ngrow in the grace and knowledge of the Lord Jesus Christ according to 2 Peter 3:18. Faithful church attendance helps create a balance in life\r\nand allows the students to see life from God\u2019s point of view.<\/p><span class='rmform-error-message' id='rmform-htmlp_1161-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-radio-1162' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1162'><span class=\"rmform-label\" > Church Attendance<span class='rmform-req-symbol'>*<\/span><\/span><div class='rmform-field-horizontal-row'><label class='rmform-check' for='Radio_1162_0'><input name=\"Radio_1162\" class=\"rmform-control radio_1162 \" aria-describedby=\"rm-note-1162\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1162_0\" value=\"Weekly\" aria-labelledby=\"label_id_Radio_1162_0\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1162_0\"  >Weekly<\/span><\/label><label class='rmform-check' for='Radio_1162_1'><input name=\"Radio_1162\" class=\"rmform-control radio_1162 \" aria-describedby=\"rm-note-1162\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1162_1\" value=\"Monthly\" aria-labelledby=\"label_id_Radio_1162_1\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1162_1\"  >Monthly<\/span><\/label><label class='rmform-check' for='Radio_1162_2'><input name=\"Radio_1162\" class=\"rmform-control radio_1162 \" aria-describedby=\"rm-note-1162\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1162_2\" value=\"Occasionally\" aria-labelledby=\"label_id_Radio_1162_2\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1162_2\"  >Occasionally<\/span><\/label><label class='rmform-check' for='Radio_1162_3'><input name=\"Radio_1162\" class=\"rmform-control radio_1162 \" aria-describedby=\"rm-note-1162\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1162_3\" value=\"Rarely\/Never\" aria-labelledby=\"label_id_Radio_1162_3\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1162_3\"  >Rarely\/Never<\/span><\/label><\/div><span class='rmform-error-message' id='rmform-radio_1162-error'><\/span><div id='rm-note-1162' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1163' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1163'><label for=\"input_id_Textbox_1163\" id=\"label_id_Textbox_1163\" class=\"rmform-label\" >  Church Attending<\/label><input type=\"text\" name=\"Textbox_1163\" class=\"rmform-control \" aria-describedby=\"rm-note-1163\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1163\" aria-labelledby=\"label_id_Textbox_1163\" placeholder=\"\"  ><span class='rmform-error-message' id='rmform-textbox_1163-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-divider-1167' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1167'><hr class=\"rmform-divider \" width=\"100%\" size=\"8\" align=\"center\" ><span class='rmform-error-message' id='rmform-divider_1167-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-htmlh-1168' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1168'><h1 class=\"rmform-field-type-heading rmform-control \" >Permissions<\/h1><span class='rmform-error-message' id='rmform-htmlh_1168-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-radio-1169' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1169'><span class=\"rmform-label\" > Field Trip Permission: We hereby grant permission for our child to be taken on field trips, outings, competitive athletic events, choir tours, or other extra-curricular activities.<span class='rmform-req-symbol'>*<\/span><\/span><div class='rmform-field-horizontal-row'><label class='rmform-check' for='Radio_1169_0'><input name=\"Radio_1169\" class=\"rmform-control radio_1169 \" aria-describedby=\"rm-note-1169\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1169_0\" value=\"Yes\" aria-labelledby=\"label_id_Radio_1169_0\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1169_0\"  >Yes<\/span><\/label><label class='rmform-check' for='Radio_1169_1'><input name=\"Radio_1169\" class=\"rmform-control radio_1169 \" aria-describedby=\"rm-note-1169\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1169_1\" value=\"No\" aria-labelledby=\"label_id_Radio_1169_1\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1169_1\"  >No<\/span><\/label><\/div><span class='rmform-error-message' id='rmform-radio_1169-error'><\/span><div id='rm-note-1169' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-radio-1170' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1170'><span class=\"rmform-label\" > We grant the staff or agents of Williston Trinity Christian School (WTCS) permission to seek emergency medical services for my child if the need arises while at school or school-related activities.<span class='rmform-req-symbol'>*<\/span><\/span><div class='rmform-field-horizontal-row'><label class='rmform-check' for='Radio_1170_0'><input name=\"Radio_1170\" class=\"rmform-control radio_1170 \" aria-describedby=\"rm-note-1170\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1170_0\" value=\"Yes\" aria-labelledby=\"label_id_Radio_1170_0\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1170_0\"  >Yes<\/span><\/label><label class='rmform-check' for='Radio_1170_1'><input name=\"Radio_1170\" class=\"rmform-control radio_1170 \" aria-describedby=\"rm-note-1170\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1170_1\" value=\"No\" aria-labelledby=\"label_id_Radio_1170_1\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1170_1\"  >No<\/span><\/label><\/div><span class='rmform-error-message' id='rmform-radio_1170-error'><\/span><div id='rm-note-1170' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-radio-1171' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1171'><span class=\"rmform-label\" > Student Media Waiver: I grant WTCS the right to take photographs of my child. I authorize WTCS, its assignees, and transferees to copyright, use, and publish the same in print and\/or electronically. I agree that WTCS may use such photographs of my child with or without my name and for any lawful purpose, including but not limited to publicity, illustration, advertising, and web content.<span class='rmform-req-symbol'>*<\/span><\/span><div class='rmform-field-horizontal-row'><label class='rmform-check' for='Radio_1171_0'><input name=\"Radio_1171\" class=\"rmform-control radio_1171 \" aria-describedby=\"rm-note-1171\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1171_0\" value=\"Yes\" aria-labelledby=\"label_id_Radio_1171_0\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1171_0\"  >Yes<\/span><\/label><label class='rmform-check' for='Radio_1171_1'><input name=\"Radio_1171\" class=\"rmform-control radio_1171 \" aria-describedby=\"rm-note-1171\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" required aria-required=\"true\" id=\"Radio_1171_1\" value=\"No\" aria-labelledby=\"label_id_Radio_1171_1\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1171_1\"  >No<\/span><\/label><\/div><span class='rmform-error-message' id='rmform-radio_1171-error'><\/span><div id='rm-note-1171' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-radio-1172' class='rm-address-field-wrap rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1172'><span class=\"rmform-label\" > Internal Photo Permission (only within WTCS): I grant WTCS the right to take photographs of my child. I authorize WTCS, its assignees, and transferees to print and use these photographs ONLY within the WTCS facility. Photographs of my child may NOT be used for public access use such as publicity, advertising, or web content.<\/span><div class='rmform-field-horizontal-row'><label class='rmform-check' for='Radio_1172_0'><input name=\"Radio_1172\" class=\"rmform-control radio_1172  data-conditional-revamp\" aria-describedby=\"rm-note-1172\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" data-cond-option=\"Radio_1171\" data-cond-value=\"No\" data-cond-operator=\"==\" data-cond-action=\"show\" id=\"Radio_1172_0\" value=\"Yes\" aria-labelledby=\"label_id_Radio_1172_0\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1172_0\"  >Yes<\/span><\/label><label class='rmform-check' for='Radio_1172_1'><input name=\"Radio_1172\" class=\"rmform-control radio_1172  data-conditional-revamp\" aria-describedby=\"rm-note-1172\" type=\"radio\" onchange=\"rmToggleOtherText(this)\" data-cond-option=\"Radio_1171\" data-cond-value=\"No\" data-cond-operator=\"==\" data-cond-action=\"show\" id=\"Radio_1172_1\" value=\"No\" aria-labelledby=\"label_id_Radio_1172_1\" ><span class=\"rmform-label rmform-radio-check\" id=\"label_id_Radio_1172_1\"  >No<\/span><\/label><\/div><span class='rmform-error-message' id='rmform-radio_1172-error'><\/span><div id='rm-note-1172' class='rmform-note' style='display: none;'><\/div><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-divider-1178' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1178'><hr class=\"rmform-divider \" width=\"100%\" size=\"8\" align=\"center\" ><span class='rmform-error-message' id='rmform-divider_1178-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-htmlh-1179' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1179'><h1 class=\"rmform-field-type-heading rmform-control \" >Statement of Parent Commitment<\/h1><span class='rmform-error-message' id='rmform-htmlh_1179-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-richtext-1180' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1180'><div class=\"rmform-control \" ><p><span style=\"font-weight: 400\">As parent(s) we recognize that we are fully responsible for our child(ren). Nevertheless, in applying for enrollment at Williston Trinity Christian School, we place him\/her under the authority of the school and are supportive of the goals and standards of the school. If your child is admitted we agree to the following:\u00a0\u00a0<\/span><\/p>\r\n<p>&nbsp;<\/p>\r\n<ol>\r\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">I will contribute my time and abilities to the school continually, as needed.\u00a0\u00a0<\/span><\/li>\r\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">I will support and uphold the school staff and board in matters of discipline.\u00a0\u00a0<\/span><\/li>\r\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">I will encourage my child in <\/span><span style=\"font-weight: 400\">positive attitudes<\/span><span style=\"font-weight: 400\"> toward the school <\/span><span style=\"font-weight: 400\">by my own conversation and attitude<\/span><em><span style=\"font-weight: 400\">.\u00a0\u00a0<\/span><\/em><\/li>\r\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">I will <\/span><span style=\"font-weight: 400\">cooperate<\/span><span style=\"font-weight: 400\"> in training my child to respect school property and pay for any abuse or damages.\u00a0\u00a0<\/span><\/li>\r\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">I will attend parent functions.\u00a0\u00a0<\/span><\/li>\r\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">I will follow the school's communication policy concerning any problem or grievance.\u00a0 I will not discuss a school problem with friends or other parents until it has been dealt with through the proper channels (i.e., discussing it with the teacher, principal, or head of school as appropriate).<\/span><\/li>\r\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">I will make prompt tuition payments and notify the business manager if a problem arises.\u00a0\u00a0<\/span><\/li>\r\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">I will give immediate attention to any academic concerns expressed by the teacher.<\/span><\/li>\r\n<\/ol>\r\n<p><span style=\"font-weight: 400\">We hereby certify that the information submitted in this application is both true and accurate.\u00a0 We understand that on admission, we agree to abide by <\/span><span style=\"font-weight: 400\">the above <\/span><span style=\"font-weight: 400\">Parent Commitment<\/span><span style=\"font-weight: 400\"> and <\/span><span style=\"font-weight: 400\">the guidelines in the student handbook<\/span><span style=\"font-weight: 400\">, as well as full agreement with the<\/span><span style=\"font-weight: 400\"> school\u2019s Statement of Faith or (Statement of Parent Support).<\/span><\/p><\/div><span class='rmform-error-message' id='rmform-richtext_1180-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-richtext-1181' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1181'><div class=\"rmform-control \" ><p>&nbsp;<\/p>\r\n<p><span style=\"font-family: verdana, geneva, sans-serif\"><b>As parents we specifically agree to:<\/b> <i>(MUST be signed by both)<\/i><\/span><\/p>\r\n<ol>\r\n<li><span style=\"font-weight: 400\"><strong>Pay<\/strong> full tuition and fees as agreed upon by the parent and the school.<\/span><\/li>\r\n<li><strong>Participate<\/strong> in the school\u2019s two required fundraising events.\u00a0<\/li>\r\n<li><strong>Serve<\/strong> the required volunteer hours.<\/li>\r\n<li><strong>Support<\/strong> the school\u2019s personal electronic device policy.<\/li>\r\n<li><strong>Support<\/strong> the school\u2019s dress code policy.<\/li>\r\n<li>Hold our child(ren) accountable for promptness when arriving at school in the morning and passing from class to class throughout the day.<\/li>\r\n<li>Provision of a laptop and secured internet access for students with usage only in approved school settings and during appropriate class periods.<\/li>\r\n<li>Hold our child(ren) accountable for turning in assignments and projects on time, understanding penalties will be enforced when this is violated.<\/li>\r\n<\/ol><\/div><span class='rmform-error-message' id='rmform-richtext_1181-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1182' class='rmform-col rmform-col-6'><div class='rmform-field' data-field-id='1182'><label for=\"input_id_Textbox_1182\" id=\"label_id_Textbox_1182\" class=\"rmform-label\" >  Father's (or Guardian) Signature<span class='rmform-req-symbol'>*<\/span><\/label><input type=\"text\" name=\"Textbox_1182\" class=\"rmform-control \" aria-describedby=\"rm-note-1182\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1182\" aria-labelledby=\"label_id_Textbox_1182\" placeholder=\"\" required aria-required=\"true\"  ><span class='rmform-error-message' id='rmform-textbox_1182-error'><\/span><\/div><\/div><div id='rm-jqueryuidate-1183' class='rmform-col rmform-col-6'><div class='rmform-field' data-field-id='1183'><label for=\"input_id_jQueryUIDate_1183\" id=\"label_id_jQueryUIDate_1183\" class=\"rmform-label\" > Date<span class='rmform-req-symbol'>*<\/span><\/label><input type=\"text\" name=\"jQueryUIDate_1183\" class=\"rmform-control datepicker\" aria-describedby=\"rm-note-1183\" autocomplete=\"off\" readonly data-dateformat=\"mm\/dd\/yy\" data-fieldtype=\"jQueryUIDate\" aria-labelledby=\"label_id_jQueryUIDate_1183\" id=\"input_id_jQueryUIDate_1183\" placeholder=\"\" required aria-required=\"true\"  ><span class='rmform-error-message' id='rmform-jqueryuidate_1183-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-textbox-1184' class='rmform-col rmform-col-6'><div class='rmform-field' data-field-id='1184'><label for=\"input_id_Textbox_1184\" id=\"label_id_Textbox_1184\" class=\"rmform-label\" >  Mother's Signature<span class='rmform-req-symbol'>*<\/span><\/label><input type=\"text\" name=\"Textbox_1184\" class=\"rmform-control \" aria-describedby=\"rm-note-1184\" minlength=\"\" maxlength=\"\" value=\"\" id=\"input_id_Textbox_1184\" aria-labelledby=\"label_id_Textbox_1184\" placeholder=\"\" required aria-required=\"true\"  ><span class='rmform-error-message' id='rmform-textbox_1184-error'><\/span><\/div><\/div><div id='rm-jqueryuidate-1185' class='rmform-col rmform-col-6'><div class='rmform-field' data-field-id='1185'><label for=\"input_id_jQueryUIDate_1185\" id=\"label_id_jQueryUIDate_1185\" class=\"rmform-label\" > Date<span class='rmform-req-symbol'>*<\/span><\/label><input type=\"text\" name=\"jQueryUIDate_1185\" class=\"rmform-control datepicker\" aria-describedby=\"rm-note-1185\" autocomplete=\"off\" readonly data-dateformat=\"mm\/dd\/yy\" data-fieldtype=\"jQueryUIDate\" aria-labelledby=\"label_id_jQueryUIDate_1185\" id=\"input_id_jQueryUIDate_1185\" placeholder=\"\" required aria-required=\"true\"  ><span class='rmform-error-message' id='rmform-jqueryuidate_1185-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-imagev-1186' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1186'><div class='rmrow'><figure class='rm-image-widget wp-caption imgv_shape_square' rmform-control ><img title='2025-2026 WTCS-qrcode' style=\"border:solid;border-color:#FFFFFF;border-width:5;\" src='https:\/\/www.wtcsnd.org\/wp-content\/uploads\/2024\/01\/2025-2026-WTCS-qrcode.png' \/><figcaption class='wp-caption-text'><\/figcaption><\/figure><\/div><span class='rmform-error-message' id='rmform-imagev_1186-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-link-1187' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1187'><a class=\"rmform-control \" href=\"https:\/\/www.paypal.com\/ncp\/payment\/YNUS8APBMMW9S\" target=\"_blank\" >  Please Use the Following QR Code or This Link to Pay Your Application Fee of $50 per student.<\/a><span class='rmform-error-message' id='rmform-link_1187-error'><\/span><\/div><\/div><\/div><\/div><div class='rmform-row'><div class='rmform-row-field-wrap'  style='--rm-field-gutter: 10px;'><div id='rm-file-1188' class='rmform-col rmform-col-12'><div class='rmform-field' data-field-id='1188'><label for=\"input_id_File_1188\" id=\"label_id_File_1188\" class=\"rmform-label\" > Upload Payment Receipt here<span class='rmform-req-symbol'>*<\/span><\/label><input type=\"file\" name=\"File_1188[]\" class=\"rmform-control \" aria-describedby=\"rm-note-1188\" id=\"input_id_File_1188\" aria-labelledby=\"label_id_File_1188\" data-fieldtype=\"File\" multiple required aria-required=\"true\"  ><span class='rmform-error-message' id='rmform-file_1188-error'><\/span><\/div><\/div><\/div><\/div><\/div><div id='rm-last-fields'><input type='hidden' name='form_id' value='23'><input type='hidden' name='form_no' value='1'><input type='hidden' name='rm_cond_hidden_fields' id='rm_cond_hidden_fields' value=''><input type='hidden' name='stat_id' value='12453'><\/div><div id='rm_form_submit_button' class='rm-form-btn-align-center'><input type='submit' id='rm-form-submit-btn' value='Submit'><\/div><\/form><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":11,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-7724","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.wtcsnd.org\/index.php?rest_route=\/wp\/v2\/pages\/7724","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.wtcsnd.org\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.wtcsnd.org\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.wtcsnd.org\/index.php?rest_route=\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/www.wtcsnd.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=7724"}],"version-history":[{"count":1,"href":"https:\/\/www.wtcsnd.org\/index.php?rest_route=\/wp\/v2\/pages\/7724\/revisions"}],"predecessor-version":[{"id":7725,"href":"https:\/\/www.wtcsnd.org\/index.php?rest_route=\/wp\/v2\/pages\/7724\/revisions\/7725"}],"wp:attachment":[{"href":"https:\/\/www.wtcsnd.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=7724"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}