chooseyoureducation.com
Open in
urlscan Pro
2606:4700:3033::6815:4a87
Public Scan
URL:
https://chooseyoureducation.com/
Submission: On April 26 via api from US — Scanned from DE
Submission: On April 26 via api from US — Scanned from DE
Form analysis
1 forms found in the DOMPOST /flow?uid=5a0460e4-e8ff-4990-bcdf-967a22049573
<form id="formSubmit" action="/flow?uid=5a0460e4-e8ff-4990-bcdf-967a22049573" method="POST" data-effect="" data-effect-duration="">
<div id="f1" class="dynamic-form form-step form1 form1-1">
<div class="row row-spacing" data-row-id="1">
<div id="col-field-cf_area_of_studies" class="col select-area-of-studies x-2 form-field-col" data-col-id="1" data-autohide="">
<label class="label">What is your desired area of study?</label>
<div id="cf_area_of_studies" class="path-dynamic-field path-cf-checkbox path-form-field-with-feedback-control">
<div class="cf_check">
<label class="cf_check__label" for="cf_area_of_studies_0">
<input class="cf_check__input cf_check_multiple path-dynamic-field " type="checkbox" data-custom="cf_area_of_studies" name="cf_area_of_studies" id="cf_area_of_studies_0" value="art-design">
<span>Art & Design</span>
</label>
</div>
<div class="cf_check">
<label class="cf_check__label" for="cf_area_of_studies_1">
<input class="cf_check__input cf_check_multiple path-dynamic-field " type="checkbox" data-custom="cf_area_of_studies" name="cf_area_of_studies" id="cf_area_of_studies_1" value="business">
<span>Business</span>
</label>
</div>
<div class="cf_check">
<label class="cf_check__label" for="cf_area_of_studies_2">
<input class="cf_check__input cf_check_multiple path-dynamic-field " type="checkbox" data-custom="cf_area_of_studies" name="cf_area_of_studies" id="cf_area_of_studies_2" value="computers-technology">
<span>Computers & Technology</span>
</label>
</div>
<div class="cf_check">
<label class="cf_check__label" for="cf_area_of_studies_3">
<input class="cf_check__input cf_check_multiple path-dynamic-field " type="checkbox" data-custom="cf_area_of_studies" name="cf_area_of_studies" id="cf_area_of_studies_3" value="education-teaching">
<span>Education & Teaching</span>
</label>
</div>
<div class="cf_check">
<label class="cf_check__label" for="cf_area_of_studies_4">
<input class="cf_check__input cf_check_multiple path-dynamic-field " type="checkbox" data-custom="cf_area_of_studies" name="cf_area_of_studies" id="cf_area_of_studies_4" value="engineering">
<span>Engineering</span>
</label>
</div>
<div class="cf_check">
<label class="cf_check__label" for="cf_area_of_studies_5">
<input class="cf_check__input cf_check_multiple path-dynamic-field " type="checkbox" data-custom="cf_area_of_studies" name="cf_area_of_studies" id="cf_area_of_studies_5" value="health-medical">
<span>Health & Medical</span>
</label>
</div>
<div class="cf_check">
<label class="cf_check__label" for="cf_area_of_studies_6">
<input class="cf_check__input cf_check_multiple path-dynamic-field " type="checkbox" data-custom="cf_area_of_studies" name="cf_area_of_studies" id="cf_area_of_studies_6" value="law-criminal-justice">
<span>Law & Criminal Justice</span>
</label>
</div>
<div class="cf_check">
<label class="cf_check__label" for="cf_area_of_studies_7">
<input class="cf_check__input cf_check_multiple path-dynamic-field " type="checkbox" data-custom="cf_area_of_studies" name="cf_area_of_studies" id="cf_area_of_studies_7" value="liberal-arts-humanities">
<span>Liberal Arts & Humanities</span>
</label>
</div>
<div class="cf_check">
<label class="cf_check__label" for="cf_area_of_studies_8">
<input class="cf_check__input cf_check_multiple path-dynamic-field " type="checkbox" data-custom="cf_area_of_studies" name="cf_area_of_studies" id="cf_area_of_studies_8" value="nursing">
<span>Nursing</span>
</label>
</div>
<div class="cf_check">
<label class="cf_check__label" for="cf_area_of_studies_9">
<input class="cf_check__input cf_check_multiple path-dynamic-field " type="checkbox" data-custom="cf_area_of_studies" name="cf_area_of_studies" id="cf_area_of_studies_9" value="science-math">
<span>Science & Math</span>
</label>
</div>
<div class="cf_check">
<label class="cf_check__label" for="cf_area_of_studies_10">
<input class="cf_check__input cf_check_multiple path-dynamic-field " type="checkbox" data-custom="cf_area_of_studies" name="cf_area_of_studies" id="cf_area_of_studies_10" value="social-science">
<span>Social Science</span>
</label>
</div>
<div class="cf_check">
<label class="cf_check__label" for="cf_area_of_studies_11">
<input class="cf_check__input cf_check_multiple path-dynamic-field " type="checkbox" data-custom="cf_area_of_studies" name="cf_area_of_studies" id="cf_area_of_studies_11" value="trade-technical">
<span>Trade & Technical</span>
</label>
</div>
</div>
<span id="cf_area_of_studies-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#cf_area_of_studies').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#cf_area_of_studies-error-feedback')
var container = this
var elemOptions = {}
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('cf_area_of_studies')
evt.detail.setFieldOptions(
'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%3D%3D'
)
evt.detail.overrideOnChangeListener(function() {})
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(container),
show: renders.hideParentFieldForm(container, false),
populate: {
prepopulate_with: function(value) {
if (value) value.split(',').forEach(function(key) {
var elem = elemOptions[key]
if (elem) elem.checked = true
})
},
populate_options: renders.fillHTMLOptions(container, 'cf_area_of_studies', function(option, id) {
return `
<div class="cf_check">
<label class="cf_check__label" for="${id}">
<input class="cf_check__input cf_check_multiple path-dynamic-field " type="checkbox" data-custom="cf_area_of_studies" name="cf_area_of_studies" id="${id}" value="${option.value}">
<span>${option.label}</span>
</label>
</div>`
}, function(option, elem) {
elemOptions[option.value] = elem
return evt.detail.listener(function(e, getValue) {
getValue(function(value) {
if (e.target.checked) return value ? value.split(',').concat(option.value).join(',') : option.value
else return (value || '').split(',').filter(function(d) {
return d !== option.value
}).join(',')
})
})
}, ``, ``)
},
validation: renders.fillFeedbackMessage(feedbackElem),
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="2">
<div id="col-field-html" class="col html form-field-col-ignored" data-col-id="1" data-autohide="">
<div id="path-field-html-1-2-1" class="path-dynamic-field">
<p>We will collect your contact information to respond to your requests for information and provide you with educational matching services. As a result, you may be matched to one or more sponsored schools from which we receive compensation.
Compensation may impact where Sponsored Schools appear on our websites. We use cookies and other tracking technologies to collect your personal information in order to gauge online activity on our website, measure the effectiveness of
online services, applications, and tools. For more information, see our <a href="/privacy-policy">privacy policy.</a></p>
</div>
<script>
document.querySelector('#path-field-html-1-2-1').addEventListener('path-dynamic-field-register', function(evt) {
var elem = this
elem.fieldContent = elem.innerHTML
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillMergetagsHTML(elem)
},
}
})
})
</script>
</div>
</div>
</div>
<div id="f2" class="dynamic-form form-step form2 form1-2 hidden">
<div class="row row-spacing" data-row-id="1">
<div id="col-field-cf_education_level_id" class="col select-education-level x-2 form-field-col" data-col-id="1" data-autohide="">
<label class="label">What is the highest level of education you have achieved?</label>
<div id="cf_education_level_id" class="path-dynamic-field path-form-field-with-feedback-control path-cf-radio">
<div class="cf_radio">
<label class="cf_radio__label" for="cf_education_level_id_0">
<input class="cf_radio__input " type="radio" data-custom="cf_education_level_id" name="cf_education_level_id" id="cf_education_level_id_0" value="education-level-no-high-school-diploma">
<span>No High School Diploma</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_education_level_id_1">
<input class="cf_radio__input " type="radio" data-custom="cf_education_level_id" name="cf_education_level_id" id="cf_education_level_id_1" value="education-level-high-school-diploma">
<span>High School Diploma</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_education_level_id_2">
<input class="cf_radio__input " type="radio" data-custom="cf_education_level_id" name="cf_education_level_id" id="cf_education_level_id_2" value="education-level-ged">
<span>GED</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_education_level_id_3">
<input class="cf_radio__input " type="radio" data-custom="cf_education_level_id" name="cf_education_level_id" id="cf_education_level_id_3" value="education-level-some-college-1-29-credits">
<span>Some College (1-29 credits)</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_education_level_id_4">
<input class="cf_radio__input " type="radio" data-custom="cf_education_level_id" name="cf_education_level_id" id="cf_education_level_id_4" value="education-level-some-college-30-59-credits">
<span>Some College (30-59 credits)</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_education_level_id_5">
<input class="cf_radio__input " type="radio" data-custom="cf_education_level_id" name="cf_education_level_id" id="cf_education_level_id_5" value="education-level-some-college-60-credits">
<span>Some College (60+ credits)</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_education_level_id_6">
<input class="cf_radio__input " type="radio" data-custom="cf_education_level_id" name="cf_education_level_id" id="cf_education_level_id_6" value="education-level-associates-degree">
<span>Associates Degree</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_education_level_id_7">
<input class="cf_radio__input " type="radio" data-custom="cf_education_level_id" name="cf_education_level_id" id="cf_education_level_id_7" value="education-level-masters-degree">
<span>Masters Degree</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_education_level_id_8">
<input class="cf_radio__input " type="radio" data-custom="cf_education_level_id" name="cf_education_level_id" id="cf_education_level_id_8" value="education-level-doctorates-phd">
<span>Doctorates/PhD</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_education_level_id_9">
<input class="cf_radio__input " type="radio" data-custom="cf_education_level_id" name="cf_education_level_id" id="cf_education_level_id_9" value="education-level-bachelors-degree">
<span>Bachelors Degree</span>
</label>
</div>
</div>
<span id="cf_education_level_id-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#cf_education_level_id').addEventListener('path-dynamic-field-register', function(evt) {
var container = this
var elemOptions = {}
var feedbackElem = document.querySelector('#cf_education_level_id-error-feedback')
evt.detail.setControls('eyJwb3B1bGF0ZSI6eyJhY3Rpb25zIjpbXSwicGxhY2Vob2xkZXIiOm51bGx9LCJ2aXNpYmlsaXR5IjpudWxsLCJ2YWxpZGF0aW9ucyI6bnVsbH0%3D')
evt.detail.assignToState('cf_education_level_id')
evt.detail.overrideOnChangeListener(function() {})
evt.detail.setFieldOptions(
'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%3D%3D'
)
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(container),
show: renders.hideParentFieldForm(container, false),
validation: renders.fillFeedbackMessage(feedbackElem),
populate: {
prepopulate_with: function(key) {
var elem = elemOptions[key]
if (elem) elem.checked = true
},
populate_options: renders.fillHTMLOptions(container, 'cf_education_level_id', function(option, id) {
return `
<div class="cf_radio">
<label class="cf_radio__label" for="${id}">
<input class="cf_radio__input " type="radio" data-custom="cf_education_level_id" name="cf_education_level_id" id="${id}" value="${option.value}">
<span>${option.label}</span>
</label>
</div>`
}, function(option, elem) {
elemOptions[option.value] = elem
return evt.detail.listener(function(e, getValue) {
getValue(function(value) {
return e.target.checked ? option.value : value
})
})
}, ``, ``)
},
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="2">
<div id="col-field-cf_grad_year" class="col select-select-year form-field-col" data-col-id="1" data-autohide="">
<label class="label">What year did you obtain your high school diploma or GED?</label>
<select id="cf_grad_year" data-custom="cf_grad_year" name="cf_grad_year" title="What year did you obtain your high school diploma or GED?" class="path-form-field-with-feedback path-dynamic-field ">
<option value=""> Select Option </option>
<option value="1960">1960</option>
<option value="1961">1961</option>
<option value="1962">1962</option>
<option value="1963">1963</option>
<option value="1964">1964</option>
<option value="1965">1965</option>
<option value="1966">1966</option>
<option value="1967">1967</option>
<option value="1968">1968</option>
<option value="1969">1969</option>
<option value="1970">1970</option>
<option value="1971">1971</option>
<option value="1972">1972</option>
<option value="1973">1973</option>
<option value="1974">1974</option>
<option value="1975">1975</option>
<option value="1976">1976</option>
<option value="1977">1977</option>
<option value="1978">1978</option>
<option value="1979">1979</option>
<option value="1980">1980</option>
<option value="1981">1981</option>
<option value="1982">1982</option>
<option value="1983">1983</option>
<option value="1984">1984</option>
<option value="1985">1985</option>
<option value="1986">1986</option>
<option value="1987">1987</option>
<option value="1988">1988</option>
<option value="1989">1989</option>
<option value="1990">1990</option>
<option value="1991">1991</option>
<option value="1992">1992</option>
<option value="1993">1993</option>
<option value="1994">1994</option>
<option value="1995">1995</option>
<option value="1996">1996</option>
<option value="1997">1997</option>
<option value="1998">1998</option>
<option value="1999">1999</option>
<option value="2000">2000</option>
<option value="2001">2001</option>
<option value="2002">2002</option>
<option value="2003">2003</option>
<option value="2004">2004</option>
<option value="2005">2005</option>
<option value="2006">2006</option>
<option value="2007">2007</option>
<option value="2008">2008</option>
<option value="2009">2009</option>
<option value="2010">2010</option>
<option value="2011">2011</option>
<option value="2012">2012</option>
<option value="2013">2013</option>
<option value="2014">2014</option>
<option value="2015">2015</option>
<option value="2016">2016</option>
<option value="2017">2017</option>
<option value="2018">2018</option>
<option value="2019">2019</option>
<option value="2020">2020</option>
<option value="2021">2021</option>
<option value="2022">2022</option>
<option value="2023">2023</option>
<option value="2024">2024</option>
</select>
<span id="cf_grad_year-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#cf_grad_year').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#cf_grad_year-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.overrideOnChangeListener(function() {
elem.addEventListener('change', evt.detail.listener(function(evt, setValue) {
setValue(evt.target.value)
}))
})
evt.detail.setFieldOptions(
'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%3D'
)
evt.detail.assignToState('cf_grad_year')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
populate_options: renders.fillSelectOptions(elem, `
Select Option
`),
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="3">
<div id="col-field-cf_rn_license" class="col select-registered-nurse form-field-col" data-col-id="1" data-autohide="false">
<label class="label">Do you have a current, unrestricted RN, LPN, or LVN license?</label>
<select id="cf_rn_license" data-custom="cf_rn_license" name="cf_rn_license" title="Do you have a current, unrestricted RN, LPN, or LVN license?" class="path-form-field-with-feedback path-dynamic-field ">
<option value=""> Select Option </option>
<option value="registered-nurse-yes">Yes</option>
<option value="registered-nurse-no">No</option>
</select>
<span id="cf_rn_license-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#cf_rn_license').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#cf_rn_license-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6eyJhY3Rpb25zIjpbXSwicGxhY2Vob2xkZXIiOm51bGx9LCJ2aXNpYmlsaXR5Ijp7InR5cGUiOiJoaWRlIiwiYWN0aW9ucyI6W10sImF1dG9oaWRlIjpmYWxzZX0sInZhbGlkYXRpb25zIjpudWxsfQ%3D%3D')
evt.detail.overrideOnChangeListener(function() {
elem.addEventListener('change', evt.detail.listener(function(evt, setValue) {
setValue(evt.target.value)
}))
})
evt.detail.setFieldOptions('W3sibGFiZWwiOiJZZXMiLCJ2YWx1ZSI6InJlZ2lzdGVyZWQtbnVyc2UteWVzIn0seyJsYWJlbCI6Ik5vIiwidmFsdWUiOiJyZWdpc3RlcmVkLW51cnNlLW5vIn1d')
evt.detail.assignToState('cf_rn_license')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
populate_options: renders.fillSelectOptions(elem, `
Select Option
`),
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="4">
<div id="col-field-cf_teaching_license" class="col select-teaching-license form-field-col hidden" data-col-id="1" data-autohide="true">
<label class="label">[select] Teaching License (hide and default to NO)</label>
<select id="cf_teaching_license" data-custom="cf_teaching_license" name="cf_teaching_license" title="[select] Teaching License (hide and default to NO)" class="path-form-field-with-feedback path-dynamic-field ">
<option value=""> Select Option </option>
<option value="teaching-license-yes">Yes</option>
<option value="teaching-license-no">No</option>
</select>
<span id="cf_teaching_license-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#cf_teaching_license').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#cf_teaching_license-error-feedback')
var elem = this
evt.detail.setControls(
'eyJwb3B1bGF0ZSI6eyJhY3Rpb25zIjpbeyJ0eXBlIjoicHJlcG9wdWxhdGVfd2l0aCIsInJ1bGVzIjp7Imdyb3VwcyI6W10sImNvbmRpdGlvbiI6Im5vbmUifSwidmFsdWUiOiJ0ZWFjaGluZy1saWNlbnNlLW5vIn1dLCJwbGFjZWhvbGRlciI6bnVsbH0sInZpc2liaWxpdHkiOnsidHlwZSI6ImhpZGUiLCJhY3Rpb25zIjpbeyJydWxlcyI6eyJncm91cHMiOltdLCJjb25kaXRpb24iOiJub25lIn19XSwiYXV0b2hpZGUiOnRydWV9LCJ2YWxpZGF0aW9ucyI6bnVsbH0%3D'
)
evt.detail.overrideOnChangeListener(function() {
elem.addEventListener('change', evt.detail.listener(function(evt, setValue) {
setValue(evt.target.value)
}))
})
evt.detail.setFieldOptions('W3sibGFiZWwiOiJZZXMiLCJ2YWx1ZSI6InRlYWNoaW5nLWxpY2Vuc2UteWVzIn0seyJsYWJlbCI6Ik5vIiwidmFsdWUiOiJ0ZWFjaGluZy1saWNlbnNlLW5vIn1d')
evt.detail.assignToState('cf_teaching_license')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
populate_options: renders.fillSelectOptions(elem, `
Select Option
`),
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="5">
<div id="col-field-cf_enrolled_status" class="col select-enrolled-in-college form-field-col hidden" data-col-id="1" data-autohide="true">
<label class="label">[select] Enrolled in College (hide and default to NO)</label>
<select id="cf_enrolled_status" data-custom="cf_enrolled_status" name="cf_enrolled_status" title="[select] Enrolled in College (hide and default to NO)" class="path-form-field-with-feedback path-dynamic-field ">
<option value=""> Select Option </option>
<option value="enrolled-status-yes">Yes</option>
<option value="enrolled-status-no">No</option>
</select>
<span id="cf_enrolled_status-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#cf_enrolled_status').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#cf_enrolled_status-error-feedback')
var elem = this
evt.detail.setControls(
'eyJwb3B1bGF0ZSI6eyJhY3Rpb25zIjpbeyJ0eXBlIjoicHJlcG9wdWxhdGVfd2l0aCIsInJ1bGVzIjp7Imdyb3VwcyI6W10sImNvbmRpdGlvbiI6Im5vbmUifSwidmFsdWUiOiJlbnJvbGxlZC1zdGF0dXMtbm8ifV0sInBsYWNlaG9sZGVyIjpudWxsfSwidmlzaWJpbGl0eSI6eyJ0eXBlIjoiaGlkZSIsImFjdGlvbnMiOlt7InJ1bGVzIjp7Imdyb3VwcyI6W10sImNvbmRpdGlvbiI6Im5vbmUifX1dLCJhdXRvaGlkZSI6dHJ1ZX0sInZhbGlkYXRpb25zIjpudWxsfQ%3D%3D'
)
evt.detail.overrideOnChangeListener(function() {
elem.addEventListener('change', evt.detail.listener(function(evt, setValue) {
setValue(evt.target.value)
}))
})
evt.detail.setFieldOptions('W3sibGFiZWwiOiJZZXMiLCJ2YWx1ZSI6ImVucm9sbGVkLXN0YXR1cy15ZXMifSx7ImxhYmVsIjoiTm8iLCJ2YWx1ZSI6ImVucm9sbGVkLXN0YXR1cy1ubyJ9XQ%3D%3D')
evt.detail.assignToState('cf_enrolled_status')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
populate_options: renders.fillSelectOptions(elem, `
Select Option
`),
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="6">
<div id="col-field-previous_step_button" class="col previous-step-button form-field-col-ignored" data-col-id="1" data-autohide="">
<button class="form-back-button path-form-previous-step-button " type="button" id="previous-step-button">
<i class="uil uil-arrow-left"></i>
<span>BACK</span>
</button>
</div>
</div>
</div>
<div id="f3" class="dynamic-form form-step form3 form1-3 hidden">
<div class="row row-spacing" data-row-id="1">
<div id="col-field-previous_step_button" class="col previous-step-button form-field-col-ignored" data-col-id="1" data-autohide="">
<button class="form-back-button path-form-previous-step-button " type="button" id="previous-step-button">
<i class="uil uil-arrow-left"></i>
<span>BACK</span>
</button>
</div>
</div>
</div>
<div id="f4" class="dynamic-form form-step form4 form1-4 hidden">
<div class="row row-spacing" data-row-id="1">
<div id="col-field-dob" class="col date-of-birth form-field-col" data-col-id="1" data-autohide="">
<label class="label">What year were you born?</label>
<div class="row path-form-field-with-feedback-control">
<div class="col">
<select id="dob_month" name="dob_month" title="Dob Month" autocomplete="bday-month" class="path-dynamic-field required">
<option value=""> Month </option>
<option value="01">Jan</option>
<option value="02">Feb</option>
<option value="03">Mar</option>
<option value="04">Apr</option>
<option value="05">May</option>
<option value="06">Jun</option>
<option value="07">Jul</option>
<option value="08">Aug</option>
<option value="09">Sep</option>
<option value="10">Oct</option>
<option value="11">Nov</option>
<option value="12">Dec</option>
</select>
</div>
<div class="col">
<select id="dob_day" name="dob_day" title="Dob Day" autocomplete="bday-day" class="path-dynamic-field required">
<option value=""> Day </option>
<option value="01">01</option>
<option value="02">02</option>
<option value="03">03</option>
<option value="04">04</option>
<option value="05">05</option>
<option value="06">06</option>
<option value="07">07</option>
<option value="08">08</option>
<option value="09">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select>
</div>
<div class="col">
<select id="dob_year" name="dob_year" title="Dob Year" autocomplete="bday-year" class="path-dynamic-field required">
<option value=""> Year </option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
<option value="1929">1929</option>
<option value="1928">1928</option>
<option value="1927">1927</option>
<option value="1926">1926</option>
<option value="1925">1925</option>
<option value="1924">1924</option>
</select>
</div>
</div>
<span id="dobmessage" class="invalid-feedback hidden path-form-feedback"></span>
<script>
var feedbackElem = document.querySelector('#dobmessage')
document.querySelector('#dob_day').addEventListener('path-dynamic-field-register', function(evt) {
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOnsiYWN0aW9ucyI6W10sInJlcXVpcmVkIjp0cnVlfX0%3D')
evt.detail.assignToState('dob_day', evt.detail.effects.age)
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
populate_options: renders.fillSelectOptions(elem, `
Day
`),
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
document.querySelector('#dob_year').addEventListener('path-dynamic-field-register', function(evt) {
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOnsiYWN0aW9ucyI6W10sInJlcXVpcmVkIjp0cnVlfX0%3D')
evt.detail.assignToState('age')
evt.detail.assignToState('dob_year', evt.detail.effects.age)
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
populate_options: renders.fillSelectOptions(elem, `
Year
`),
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
document.querySelector('#dob_month').addEventListener('path-dynamic-field-register', function(evt) {
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOnsiYWN0aW9ucyI6W10sInJlcXVpcmVkIjp0cnVlfX0%3D')
evt.detail.assignToState('dob_month', evt.detail.effects.age)
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
populate_options: renders.fillSelectOptions(elem, `
Month
`),
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="2">
<div id="col-field-cf_us_citizen" class="col select-us-citizen x-2 form-field-col" data-col-id="1" data-autohide="">
<label class="label">Are you a U.S. Citizen?</label>
<div id="cf_us_citizen" class="path-dynamic-field path-form-field-with-feedback-control path-cf-radio">
<div class="cf_radio">
<label class="cf_radio__label" for="cf_us_citizen_0">
<input class="cf_radio__input " type="radio" data-custom="cf_us_citizen" name="cf_us_citizen" id="cf_us_citizen_0" value="citizenship-yes">
<span>Yes</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_us_citizen_1">
<input class="cf_radio__input " type="radio" data-custom="cf_us_citizen" name="cf_us_citizen" id="cf_us_citizen_1" value="citizenship-no">
<span>No</span>
</label>
</div>
</div>
<span id="cf_us_citizen-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#cf_us_citizen').addEventListener('path-dynamic-field-register', function(evt) {
var container = this
var elemOptions = {}
var feedbackElem = document.querySelector('#cf_us_citizen-error-feedback')
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('cf_us_citizen')
evt.detail.overrideOnChangeListener(function() {})
evt.detail.setFieldOptions('W3sibGFiZWwiOiJZZXMiLCJ2YWx1ZSI6ImNpdGl6ZW5zaGlwLXllcyJ9LHsibGFiZWwiOiJObyIsInZhbHVlIjoiY2l0aXplbnNoaXAtbm8ifV0%3D')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(container),
show: renders.hideParentFieldForm(container, false),
validation: renders.fillFeedbackMessage(feedbackElem),
populate: {
prepopulate_with: function(key) {
var elem = elemOptions[key]
if (elem) elem.checked = true
},
populate_options: renders.fillHTMLOptions(container, 'cf_us_citizen', function(option, id) {
return `
<div class="cf_radio">
<label class="cf_radio__label" for="${id}">
<input class="cf_radio__input " type="radio" data-custom="cf_us_citizen" name="cf_us_citizen" id="${id}" value="${option.value}">
<span>${option.label}</span>
</label>
</div>`
}, function(option, elem) {
elemOptions[option.value] = elem
return evt.detail.listener(function(e, getValue) {
getValue(function(value) {
return e.target.checked ? option.value : value
})
})
}, ``, ``)
},
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="3">
<div id="col-field-cf_military_type" class="col select-millitary-affiliation mt-3 x-2 form-field-col" data-col-id="1" data-autohide="">
<label class="label">Please select your military status:</label>
<div id="cf_military_type" class="path-dynamic-field path-form-field-with-feedback-control path-cf-radio">
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_0">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_0" value="military-no-military-affiliation">
<span>No Military Affiliation</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_1">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_1" value="military-af-active-duty-ad">
<span>AF - Active Duty (AD)</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_2">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_2" value="military-af-selective-reserve-sr">
<span>AF - Selective Reserve (SR)</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_3">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_3" value="military-af-spouse-of-ad-or-sr">
<span>AF - Spouse of AD or SR</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_4">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_4" value="military-af-veteran">
<span>AF - Veteran</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_5">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_5" value="military-af-civilian">
<span>AF - Civilian</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_6">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_6" value="military-ar-active-duty-ad">
<span>AR - Active Duty (AD)</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_7">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_7" value="military-ar-selective-reserve-sr">
<span>AR - Selective Reserve (SR)</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_8">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_8" value="military-ar-spouse-of-ad-or-sr">
<span>AR - Spouse of AD or SR</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_9">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_9" value="military-ar-veteran">
<span>AR - Veteran</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_10">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_10" value="military-ar-civilian">
<span>AR - Civilian</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_11">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_11" value="military-cg-active-duty-ad">
<span>CG - Active Duty (AD)</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_12">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_12" value="military-cg-selective-reserve-sr">
<span>CG - Selective Reserve (SR)</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_13">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_13" value="military-cg-spouse-of-ad-or-sr">
<span>CG - Spouse of AD or SR</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_14">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_14" value="military-cg-veteran">
<span>CG - Veteran</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_15">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_15" value="military-cg-civilian">
<span>CG - Civilian</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_16">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_16" value="military-mc-active-duty-ad">
<span>MC - Active Duty (AD)</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_17">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_17" value="military-mc-selective-reserve-sr">
<span>MC - Selective Reserve (SR)</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_18">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_18" value="military-mc-spouse-of-ad-or-sr">
<span>MC - Spouse of AD or SR</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_19">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_19" value="military-mc-veteran">
<span>MC - Veteran</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_20">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_20" value="military-mc-civilian">
<span>MC - Civilian</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_21">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_21" value="military-nv-active-duty-ad">
<span>NV - Active Duty (AD)</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_22">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_22" value="military-nv-selective-reserve-sr">
<span>NV - Selective Reserve (SR)</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_23">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_23" value="military-nv-spouse-of-ad-or-sr">
<span>NV - Spouse of AD or SR</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_24">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_24" value="military-nv-veteran">
<span>NV - Veteran</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_military_type_25">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="cf_military_type_25" value="military-nv-civilian">
<span>NV - Civilian</span>
</label>
</div>
</div>
<span id="cf_military_type-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#cf_military_type').addEventListener('path-dynamic-field-register', function(evt) {
var container = this
var elemOptions = {}
var feedbackElem = document.querySelector('#cf_military_type-error-feedback')
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('cf_military_type')
evt.detail.overrideOnChangeListener(function() {})
evt.detail.setFieldOptions(
'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%3D%3D'
)
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(container),
show: renders.hideParentFieldForm(container, false),
validation: renders.fillFeedbackMessage(feedbackElem),
populate: {
prepopulate_with: function(key) {
var elem = elemOptions[key]
if (elem) elem.checked = true
},
populate_options: renders.fillHTMLOptions(container, 'cf_military_type', function(option, id) {
return `
<div class="cf_radio">
<label class="cf_radio__label" for="${id}">
<input class="cf_radio__input " type="radio" data-custom="cf_military_type" name="cf_military_type" id="${id}" value="${option.value}">
<span>${option.label}</span>
</label>
</div>`
}, function(option, elem) {
elemOptions[option.value] = elem
return evt.detail.listener(function(e, getValue) {
getValue(function(value) {
return e.target.checked ? option.value : value
})
})
}, ``, ``)
},
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="4">
<div id="col-field-previous_step_button" class="col previous-step-button form-field-col-ignored" data-col-id="1" data-autohide="">
<button class="form-back-button path-form-previous-step-button " type="button" id="previous-step-button">
<i class="uil uil-arrow-left"></i>
<span>BACK</span>
</button>
</div>
</div>
</div>
<div id="f5" class="dynamic-form form-step form5 form1-5 hidden">
<div class="row row-spacing" data-row-id="1">
<div id="col-field-cf_start_date" class="col select-start-date x-2 form-field-col" data-col-id="1" data-autohide="">
<label class="label">When would you like to start:</label>
<div id="cf_start_date" class="path-dynamic-field path-form-field-with-feedback-control path-cf-radio">
<div class="cf_radio">
<label class="cf_radio__label" for="cf_start_date_0">
<input class="cf_radio__input required" type="radio" data-custom="cf_start_date" name="cf_start_date" id="cf_start_date_0" value="desired-start-date-immediately">
<span>Immediately</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_start_date_1">
<input class="cf_radio__input required" type="radio" data-custom="cf_start_date" name="cf_start_date" id="cf_start_date_1" value="desired-start-date-1-3-months">
<span>1-3 Months</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_start_date_2">
<input class="cf_radio__input required" type="radio" data-custom="cf_start_date" name="cf_start_date" id="cf_start_date_2" value="desired-start-date-4-6-months">
<span>4-6 Months</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_start_date_3">
<input class="cf_radio__input required" type="radio" data-custom="cf_start_date" name="cf_start_date" id="cf_start_date_3" value="desired-start-date-7-12-months">
<span>7-12 Months</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_start_date_4">
<input class="cf_radio__input required" type="radio" data-custom="cf_start_date" name="cf_start_date" id="cf_start_date_4" value="desired-start-date-more-than-1-year">
<span>More than 1 Year</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_start_date_5">
<input class="cf_radio__input required" type="radio" data-custom="cf_start_date" name="cf_start_date" id="cf_start_date_5" value="desired-start-date-not-sure">
<span>Not Sure</span>
</label>
</div>
</div>
<span id="cf_start_date-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#cf_start_date').addEventListener('path-dynamic-field-register', function(evt) {
var container = this
var elemOptions = {}
var feedbackElem = document.querySelector('#cf_start_date-error-feedback')
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOnsiYWN0aW9ucyI6W10sInJlcXVpcmVkIjp0cnVlfX0%3D')
evt.detail.assignToState('cf_start_date')
evt.detail.overrideOnChangeListener(function() {})
evt.detail.setFieldOptions(
'W3sibGFiZWwiOiJJbW1lZGlhdGVseSIsInZhbHVlIjoiZGVzaXJlZC1zdGFydC1kYXRlLWltbWVkaWF0ZWx5In0seyJsYWJlbCI6IjEtMyBNb250aHMiLCJ2YWx1ZSI6ImRlc2lyZWQtc3RhcnQtZGF0ZS0xLTMtbW9udGhzIn0seyJsYWJlbCI6IjQtNiBNb250aHMiLCJ2YWx1ZSI6ImRlc2lyZWQtc3RhcnQtZGF0ZS00LTYtbW9udGhzIn0seyJsYWJlbCI6IjctMTIgTW9udGhzIiwidmFsdWUiOiJkZXNpcmVkLXN0YXJ0LWRhdGUtNy0xMi1tb250aHMifSx7ImxhYmVsIjoiTW9yZSB0aGFuIDEgWWVhciIsInZhbHVlIjoiZGVzaXJlZC1zdGFydC1kYXRlLW1vcmUtdGhhbi0xLXllYXIifSx7ImxhYmVsIjoiTm90IFN1cmUiLCJ2YWx1ZSI6ImRlc2lyZWQtc3RhcnQtZGF0ZS1ub3Qtc3VyZSJ9XQ%3D%3D'
)
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(container),
show: renders.hideParentFieldForm(container, false),
validation: renders.fillFeedbackMessage(feedbackElem),
populate: {
prepopulate_with: function(key) {
var elem = elemOptions[key]
if (elem) elem.checked = true
},
populate_options: renders.fillHTMLOptions(container, 'cf_start_date', function(option, id) {
return `
<div class="cf_radio">
<label class="cf_radio__label" for="${id}">
<input class="cf_radio__input required" type="radio" data-custom="cf_start_date" name="cf_start_date" id="${id}" value="${option.value}">
<span>${option.label}</span>
</label>
</div>`
}, function(option, elem) {
elemOptions[option.value] = elem
return evt.detail.listener(function(e, getValue) {
getValue(function(value) {
return e.target.checked ? option.value : value
})
})
}, ``, ``)
},
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="2">
<div id="col-field-cf_besttime_contact" class="col select-best-time-to-contact x-2 form-field-col" data-col-id="1" data-autohide="">
<label class="label">Best Time to Contact</label>
<div id="cf_besttime_contact" class="path-dynamic-field path-form-field-with-feedback-control path-cf-radio">
<div class="cf_radio">
<label class="cf_radio__label" for="cf_besttime_contact_0">
<input class="cf_radio__input " type="radio" data-custom="cf_besttime_contact" name="cf_besttime_contact" id="cf_besttime_contact_0" value="best-time-to-contact-anytime">
<span>Anytime</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_besttime_contact_1">
<input class="cf_radio__input " type="radio" data-custom="cf_besttime_contact" name="cf_besttime_contact" id="cf_besttime_contact_1" value="best-time-to-contact-morning">
<span>Morning</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_besttime_contact_2">
<input class="cf_radio__input " type="radio" data-custom="cf_besttime_contact" name="cf_besttime_contact" id="cf_besttime_contact_2" value="best-time-to-contact-afternoon">
<span>Afternoon</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_besttime_contact_3">
<input class="cf_radio__input " type="radio" data-custom="cf_besttime_contact" name="cf_besttime_contact" id="cf_besttime_contact_3" value="best-time-to-contact-evening">
<span>Evening</span>
</label>
</div>
</div>
<span id="cf_besttime_contact-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#cf_besttime_contact').addEventListener('path-dynamic-field-register', function(evt) {
var container = this
var elemOptions = {}
var feedbackElem = document.querySelector('#cf_besttime_contact-error-feedback')
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('cf_besttime_contact')
evt.detail.overrideOnChangeListener(function() {})
evt.detail.setFieldOptions(
'W3sibGFiZWwiOiJBbnl0aW1lIiwidmFsdWUiOiJiZXN0LXRpbWUtdG8tY29udGFjdC1hbnl0aW1lIn0seyJsYWJlbCI6Ik1vcm5pbmciLCJ2YWx1ZSI6ImJlc3QtdGltZS10by1jb250YWN0LW1vcm5pbmcifSx7ImxhYmVsIjoiQWZ0ZXJub29uIiwidmFsdWUiOiJiZXN0LXRpbWUtdG8tY29udGFjdC1hZnRlcm5vb24ifSx7ImxhYmVsIjoiRXZlbmluZyIsInZhbHVlIjoiYmVzdC10aW1lLXRvLWNvbnRhY3QtZXZlbmluZyJ9XQ%3D%3D'
)
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(container),
show: renders.hideParentFieldForm(container, false),
validation: renders.fillFeedbackMessage(feedbackElem),
populate: {
prepopulate_with: function(key) {
var elem = elemOptions[key]
if (elem) elem.checked = true
},
populate_options: renders.fillHTMLOptions(container, 'cf_besttime_contact', function(option, id) {
return `
<div class="cf_radio">
<label class="cf_radio__label" for="${id}">
<input class="cf_radio__input " type="radio" data-custom="cf_besttime_contact" name="cf_besttime_contact" id="${id}" value="${option.value}">
<span>${option.label}</span>
</label>
</div>`
}, function(option, elem) {
elemOptions[option.value] = elem
return evt.detail.listener(function(e, getValue) {
getValue(function(value) {
return e.target.checked ? option.value : value
})
})
}, ``, ``)
},
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="3">
<div id="col-field-cf_level_interest" class="col select-level-of-interest form-field-col" data-col-id="1" data-autohide="">
<label class="label">On a scale of 1 to 10 with 10 being the highest, how motivated are you to enroll in school?</label>
<select id="cf_level_interest" data-custom="cf_level_interest" name="cf_level_interest" title="On a scale of 1 to 10 with 10 being the highest, how motivated are you to enroll in school?"
class="path-form-field-with-feedback path-dynamic-field required">
<option value=""> Select Option </option>
<option value="level-of-interest-1">1</option>
<option value="level-of-interest-2">2</option>
<option value="level-of-interest-3">3</option>
<option value="level-of-interest-4">4</option>
<option value="level-of-interest-5">5</option>
<option value="level-of-interest-6">6</option>
<option value="level-of-interest-7">7</option>
<option value="level-of-interest-8">8</option>
<option value="level-of-interest-9">9</option>
<option value="level-of-interest-10">10</option>
</select>
<span id="cf_level_interest-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#cf_level_interest').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#cf_level_interest-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOnsiYWN0aW9ucyI6W10sInJlcXVpcmVkIjp0cnVlfX0%3D')
evt.detail.overrideOnChangeListener(function() {
elem.addEventListener('change', evt.detail.listener(function(evt, setValue) {
setValue(evt.target.value)
}))
})
evt.detail.setFieldOptions(
'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%3D'
)
evt.detail.assignToState('cf_level_interest')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
populate_options: renders.fillSelectOptions(elem, `
Select Option
`),
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="4">
<div id="col-field-cf_internet_pc" class="col select-internet-connection x-2 form-field-col" data-col-id="1" data-autohide="">
<label class="label">Do you own a PC with unrestricted reliable internet access?</label>
<div id="cf_internet_pc" class="path-dynamic-field path-form-field-with-feedback-control path-cf-radio">
<div class="cf_radio">
<label class="cf_radio__label" for="cf_internet_pc_0">
<input class="cf_radio__input required" type="radio" data-custom="cf_internet_pc" name="cf_internet_pc" id="cf_internet_pc_0" value="computer-with-internet-yes">
<span>Yes</span>
</label>
</div>
<div class="cf_radio">
<label class="cf_radio__label" for="cf_internet_pc_1">
<input class="cf_radio__input required" type="radio" data-custom="cf_internet_pc" name="cf_internet_pc" id="cf_internet_pc_1" value="computer-with-internet-no">
<span>No</span>
</label>
</div>
</div>
<span id="cf_internet_pc-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#cf_internet_pc').addEventListener('path-dynamic-field-register', function(evt) {
var container = this
var elemOptions = {}
var feedbackElem = document.querySelector('#cf_internet_pc-error-feedback')
evt.detail.setControls('eyJwb3B1bGF0ZSI6eyJhY3Rpb25zIjpbXSwicGxhY2Vob2xkZXIiOm51bGx9LCJ2aXNpYmlsaXR5IjpudWxsLCJ2YWxpZGF0aW9ucyI6eyJhY3Rpb25zIjpbXSwicmVxdWlyZWQiOnRydWV9fQ%3D%3D')
evt.detail.assignToState('cf_internet_pc')
evt.detail.overrideOnChangeListener(function() {})
evt.detail.setFieldOptions('W3sibGFiZWwiOiJZZXMiLCJ2YWx1ZSI6ImNvbXB1dGVyLXdpdGgtaW50ZXJuZXQteWVzIn0seyJsYWJlbCI6Ik5vIiwidmFsdWUiOiJjb21wdXRlci13aXRoLWludGVybmV0LW5vIn1d')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(container),
show: renders.hideParentFieldForm(container, false),
validation: renders.fillFeedbackMessage(feedbackElem),
populate: {
prepopulate_with: function(key) {
var elem = elemOptions[key]
if (elem) elem.checked = true
},
populate_options: renders.fillHTMLOptions(container, 'cf_internet_pc', function(option, id) {
return `
<div class="cf_radio">
<label class="cf_radio__label" for="${id}">
<input class="cf_radio__input required" type="radio" data-custom="cf_internet_pc" name="cf_internet_pc" id="${id}" value="${option.value}">
<span>${option.label}</span>
</label>
</div>`
}, function(option, elem) {
elemOptions[option.value] = elem
return evt.detail.listener(function(e, getValue) {
getValue(function(value) {
return e.target.checked ? option.value : value
})
})
}, ``, ``)
},
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="5">
<div id="col-field-cf_school_type" class="col select-school-type form-field-col" data-col-id="1" data-autohide="">
<label class="label">Do you prefer online or campus?</label>
<select id="cf_school_type" data-custom="cf_school_type" name="cf_school_type" title="Do you prefer online or campus?" class="path-form-field-with-feedback path-dynamic-field required">
<option value=""> Select Option </option>
<option value="1">Online</option>
<option value="2">Campus</option>
<option value="3">Both</option>
</select>
<span id="cf_school_type-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#cf_school_type').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#cf_school_type-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOnsiYWN0aW9ucyI6W10sInJlcXVpcmVkIjp0cnVlfX0%3D')
evt.detail.overrideOnChangeListener(function() {
elem.addEventListener('change', evt.detail.listener(function(evt, setValue) {
setValue(evt.target.value)
}))
})
evt.detail.setFieldOptions('W3sibGFiZWwiOiJPbmxpbmUiLCJ2YWx1ZSI6IjEifSx7ImxhYmVsIjoiQ2FtcHVzIiwidmFsdWUiOiIyIn0seyJsYWJlbCI6IkJvdGgiLCJ2YWx1ZSI6IjMifV0%3D')
evt.detail.assignToState('cf_school_type')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
populate_options: renders.fillSelectOptions(elem, `
Select Option
`),
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="6">
<div id="col-field-previous_step_button" class="col previous-step-button form-field-col-ignored" data-col-id="1" data-autohide="">
<button class="form-back-button path-form-previous-step-button " type="button" id="previous-step-button">
<i class="uil uil-arrow-left"></i>
<span>BACK</span>
</button>
</div>
</div>
</div>
<div id="f6" class="dynamic-form form-step form6 form1-6 hidden">
<div class="row row-spacing" data-row-id="1">
<div id="col-field-gender" class="col gender x-2 form-field-col" data-col-id="1" data-autohide="">
<label class="label">What is your gender?</label>
<div class="path-form-field-with-feedback">
<label for="gender_m_radio">
<input id="gender_m_radio" class="path-dynamic-field " type="radio" data-custom="gender" name="gender" value="M">
<span>Male</span>
</label>
<label for="gender_f_radio">
<input id="gender_f_radio" class="path-dynamic-field " type="radio" data-custom="gender" name="gender" value="F">
<span>Female</span>
</label>
</div>
<span id="gender-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
(function() {
var feedbackElem = document.querySelector('#gender-error-feedback')
var configure = function(evt, type, elem) {
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('gender')
evt.detail.overrideOnChangeListener(function() {
elem.addEventListener('click', evt.detail.listener(function(evt, setValue) {
if (evt.target.checked) setValue(type)
}))
})
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: function(value) {
if (value === type) elem.checked = value
}
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
}
document.querySelector('#gender_m_radio').addEventListener('path-dynamic-field-register', function(evt) {
configure(evt, 'M', this)
})
document.querySelector('#gender_f_radio').addEventListener('path-dynamic-field-register', function(evt) {
configure(evt, 'F', this)
})
})()
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="2">
<div id="col-field-first_name" class="col first-name form-field-col" data-col-id="1" data-autohide="">
<label class="label">First Name</label>
<input id="first_name" type="text" name="first_name" class="path-form-field-with-feedback path-dynamic-field " title="First Name" value="">
<span id="first_name-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#first_name').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#first_name-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('first_name')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
<div id="col-field-last_name" class="col last-name form-field-col" data-col-id="2" data-autohide="">
<label class="label">Last Name</label>
<input id="last_name" type="text" name="last_name" class="path-form-field-with-feedback path-dynamic-field " title="Last Name" value="">
<span id="last_name-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#last_name').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#last_name-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('last_name')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="3">
<div id="col-field-phone" class="col phone form-field-col" data-col-id="1" data-autohide="">
<label class="label">Mobile Phone</label>
<input id="phone" type="tel" name="phone" title="Phone" data-session-verification="-1" value="" class="path-dynamic-field path-form-field-with-feedback " pattern="[0-9]*" inputmode="numeric" autocomplete="tel-national">
<span id="phone-error-feedback" class="invalid-feedback hidden path-form-feedback invalid-phone"></span>
<script>
document.querySelector('#phone').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#phone-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('phone')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillInputPhone(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="4">
<div id="col-field-email" class="col e-mail-required form-field-col" data-col-id="1" data-autohide="">
<label class="label">E-mail</label>
<input id="email" list="email_domains" type="email" name="email" class="path-form-field-with-feedback path-dynamic-field required" title="Email" data-session-verification="-1" value="">
<span id="emailmessage" class="invalid-feedback hidden path-form-feedback"></span>
<datalist id="email_domains"></datalist>
<script>
document.querySelector('#email').addEventListener('path-dynamic-field-register', function(evt) {
var domains = ["gmail.com", "yahoo.com", "hotmail.com", "aol.com", "hotmail.co.uk", "hotmail.fr", "msn.com", "yahoo.fr", "wanadoo.fr", "orange.fr", "comcast.net", "yahoo.co.uk", "yahoo.co.in", "live.com", "rediffmail.com", "free.fr",
"gmx.de", "web.de", "yandex.ru", "ymail.com", "libero.it", "outlook.com", "uol.com", "bol.com", "mail.ru", "cox.net", "hotmail.it", "sbcglobal.net", "sfr.fr", "live.fr", "verizon.net", "live.co.uk", "googlemail.com", "yahoo.es",
"ig.com", "live.nl", "bigpond.com", "terra.com", "yahoo.it", "neuf.fr", "yahoo.de", "alice.it", "rocketmail.com", "att.net", "laposte.net", "facebook.com", "bellsouth.net", "yahoo.in", "hotmail.es", "charter.net", "yahoo.ca",
"yahoo.com.au", "rambler.ru", "hotmail.de", "tiscali.it", "shaw.ca", "yahoo.co.jp", "sky.com"
]
var feedbackElem = document.querySelector('#emailmessage')
var emailDomains = document.querySelector('#email_domains')
var elem = this
evt.detail.overrideOnChangeListener(function() {
elem.addEventListener('input', evt.detail.listener(function(evt, setValue) {
var value = evt.target.value
setValue(value)
var split = value.split('@')
var username = split[0]
var domain = split[1]
var regex = domain && new RegExp('@' + domain)
emailDomains.innerHTML = ''
domains.forEach(function(domain) {
if (regex && regex.test('@' + domain) && username + '@' + domain !== value) {
var option = emailDomains.appendChild(document.createElement('option'))
option.setAttribute('value', username + '@' + domain)
}
})
}))
})
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('test')
evt.detail.assignToState('email', evt.detail.effects.test)
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="5">
<div id="col-field-previous_step_button" class="col previous-step-button form-field-col-ignored" data-col-id="1" data-autohide="">
<button class="form-back-button path-form-previous-step-button " type="button" id="previous-step-button">
<i class="uil uil-arrow-left"></i>
<span>BACK</span>
</button>
</div>
</div>
</div>
<div id="f7" class="dynamic-form form-step form7 form1-7 hidden">
<div class="row row-spacing" data-row-id="1">
<div id="col-field-address1" class="col-8 address-1 form-field-col" data-col-id="1" data-autohide="">
<label class="label">Address</label>
<input id="addressform" type="text" name="addressform" title="Address" value="" class="path-dynamic-field path-form-field-with-feedback " autocomplete="address-line1">
<span id="address1-error-feedback" class="invalid-feedback hidden path-form-feedback invalid-postal"></span>
<input id="address1" type="hidden" name="address1" title="Address" value="">
<script>
document.querySelector('#addressform').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#address1-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('address1')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
<div id="col-field-address2" class="col address-2 form-field-col" data-col-id="2" data-autohide="">
<label class="label">Address 2</label>
<input id="address2" type="text" name="address2" value="" class="path-form-field-with-feedback path-dynamic-field " autocomplete="address-line2">
<span id="address2-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#address2').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#address2-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('address2')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="2">
<div id="col-field-city" class="col city form-field-col" data-col-id="1" data-autohide="">
<label class="label">City</label>
<input id="city" type="text" name="city" title="City" value="" class="path-form-field-with-feedback path-dynamic-field " autocomplete="address-level2">
<span id="city-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#city').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#city-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('city')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="3">
<div id="col-field-state" class="col state form-field-col" data-col-id="1" data-autohide="">
<label class="label">State</label>
<select id="state" name="state" title="State" class="path-form-field-with-feedback path-dynamic-field " value="" datavalue="">
<option value=""> Select State </option>
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AZ">Arizona</option>
<option value="AR">Arkansas</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
<option value="CT">Connecticut</option>
<option value="DE">Delaware</option>
<option value="DC">District Of Columbia</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="HI">Hawaii</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="IA">Iowa</option>
<option value="KS">Kansas</option>
<option value="KY">Kentucky</option>
<option value="LA">Louisiana</option>
<option value="ME">Maine</option>
<option value="MD">Maryland</option>
<option value="MA">Massachusetts</option>
<option value="MI">Michigan</option>
<option value="MN">Minnesota</option>
<option value="MS">Mississippi</option>
<option value="MO">Missouri</option>
<option value="MT">Montana</option>
<option value="NE">Nebraska</option>
<option value="NV">Nevada</option>
<option value="NH">New Hampshire</option>
<option value="NJ">New Jersey</option>
<option value="NM">New Mexico</option>
<option value="NY">New York</option>
<option value="NC">North Carolina</option>
<option value="ND">North Dakota</option>
<option value="OH">Ohio</option>
<option value="OK">Oklahoma</option>
<option value="OR">Oregon</option>
<option value="PA">Pennsylvania</option>
<option value="RI">Rhode Island</option>
<option value="SC">South Carolina</option>
<option value="SD">South Dakota</option>
<option value="TN">Tennessee</option>
<option value="TX">Texas</option>
<option value="UT">Utah</option>
<option value="VT">Vermont</option>
<option value="VA">Virginia</option>
<option value="WA">Washington</option>
<option value="WV">West Virginia</option>
<option value="WI">Wisconsin</option>
<option value="WY">Wyoming</option>
</select>
<span id="state-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#state').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#state-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('state')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
populate_options: renders.fillSelectOptions(elem, `
Select State
`),
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
<div id="col-field-zip" class="col-4 zip-code form-field-col" data-col-id="2" data-autohide="">
<label class="label">Zip Code</label>
<input id="zip" type="text" name="zip" title="Zipcode" maxlength="5" data-session-verification="-1" value="" class="path-form-field-with-feedback path-dynamic-field" pattern="[0-9]*" inputmode="numeric" autocomplete="postal-code">
<span id="zip-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#zip').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#zip-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('zip')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillZip(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
$(elem).change()
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="4">
<div id="col-field-registration_consent" class="col registration-consent form-field-col" data-col-id="1" data-autohide="false">
<div class="terms termschk">
<input type="checkbox" class="chkbox path-dynamic-field" id="chkterms" name="chkterms">
<label class="term-label terms-label--checkbox" for="chkterms"> By checking this box, you give your consent to be contacted on behalf of ChooseYourEducation.com and any selected schools by email and/or at the telephone number(s) provided
with automated technology, pre-recorded messages, and/or pre-recorded voices, including your wireless number if provided. This consent is not required as a condition to purchase a good or services. Msg and data rates may apply. </label>
<script>
document.querySelector('#chkterms').addEventListener('path-dynamic-field-register', function(evt) {
var elem = this
evt.detail.assignToState('registrationConsent', function(value) {
elem.dispatchEvent(new CustomEvent('path-event-registration-consent-changed'))
return elem.checked
})
})
</script>
</div>
</div>
</div>
<div class="row row-spacing" data-row-id="5">
<div id="col-field-html" class="col html form-field-col-ignored" data-col-id="1" data-autohide="">
<div id="path-field-html-7-5-1" class="path-dynamic-field">
<p><b>To opt-out of having your personal information collected, <a href="/opt-out">click here</a>.</b></p>
</div>
<script>
document.querySelector('#path-field-html-7-5-1').addEventListener('path-dynamic-field-register', function(evt) {
var elem = this
elem.fieldContent = elem.innerHTML
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillMergetagsHTML(elem)
},
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="6">
<div id="col-field-previous_step_button" class="col previous-step-button form-field-col-ignored" data-col-id="1" data-autohide="">
<button class="form-back-button path-form-previous-step-button " type="button" id="previous-step-button">
<i class="uil uil-arrow-left"></i>
<span>BACK</span>
</button>
</div>
</div>
</div>
<div class="form-row">
<div class="x-12 col-mobile center">
<button class="btn form-button submitbutton form-submit-button" type="button" id="submitbutton">
<span>Continue</span>
<i class="fa fa-spinner fa-spin"></i>
</button>
</div>
</div>
<div class="hidden">
<input type="hidden" id="numForms" name="numForms" value="7">
<input type="hidden" id="tcpaStep" name="tcpaStep" value="-1">
<input type="hidden" id="registrationStep" name="registrationStep" value="-1">
<input type="hidden" id="currentForm" name="currentForm" value="1">
<input type="hidden" id="uid" name="uid" value="5a0460e4-e8ff-4990-bcdf-967a22049573">
<input type="hidden" id="tcpaconsent" name="tcpaconsent" value="">
<input type="hidden" id="consent" name="consent" value="">
<input type="hidden" id="pathAid" name="pathAid" value="9275">
<input type="hidden" id="pathPid" name="pathPid" value="2988">
<input type="hidden" id="pathSid1" name="pathSid1" value="">
<input type="hidden" id="registrationCheck" name="registrationCheck" value="false">
<input type="hidden" id="addressCheck" name="addressCheck" value="false">
<input type="hidden" id="fraudCheck" name="fraudCheck" value="false">
<input type="hidden" id="emailValid" name="emailValid" value="false">
<input type="hidden" id="addressValid" name="addressValid" value="false">
<input type="hidden" name="origin" value="submit">
<input type="hidden" id="haddress1" value="">
<input type="hidden" id="haddress2" value="">
<input type="hidden" id="hcity" value="">
<input type="hidden" id="hstate" value="">
<input type="hidden" id="hzipcode" value="">
<div id="pixel"></div>
<script type="text/javascript">
(function() {
var field = 'xxTrustedFormCertUrl';
var provideReferrer = false;
var invertFieldSensitivity = false;
var tf = document.createElement('script');
tf.type = 'text/javascript';
tf.async = true;
tf.src = 'http' + ('https:' == document.location.protocol ? 's' : '') + '://api.trustedform.com/trustedform.js?provide_referrer=' + escape(provideReferrer) + '&field=' + escape(field) + '&l=' + new Date().getTime() + Math.random() +
'&invert_field_sensitivity=' + invertFieldSensitivity;
var s = document.getElementsByTagName('script')[0];
s.parentNode.insertBefore(tf, s);
})();
</script>
<noscript>
<img src="http://api.trustedform.com/ns.gif">
</noscript>
<input id="leadid_token" name="universal_leadid" type="hidden" value="43C46E81-F7EE-1DD8-91B2-6B60D0850CA1">
</div>
<input type="hidden" name="xxTrustedFormToken" id="xxTrustedFormToken_0" value="https://cert.trustedform.com/02f3b072615e21c3dc67d3967280327142afdc89"><input type="hidden" name="xxTrustedFormCertUrl" id="xxTrustedFormCertUrl_0"
value="https://cert.trustedform.com/02f3b072615e21c3dc67d3967280327142afdc89"><input type="hidden" name="xxTrustedFormPingUrl" id="xxTrustedFormPingUrl_0"
value="https://ping.trustedform.com/0.nmp7oObj2K_vTPieyEokdf_294VYxAm8DCtt84tYF91EJQEWYLPldwE4tG3VWtGkV-lbol0S.Cg0KA4I2NJG79Hnmrmxksg.-QgbVbwVNMd_oAOcDqK5uQ">
</form>
Text Content
YOUR LIFE... YOUR EDUCATION... YOUR CHOICE... SPONSORED SCHOOLS Step 1 of 7 20% What is your desired area of study? Art & Design Business Computers & Technology Education & Teaching Engineering Health & Medical Law & Criminal Justice Liberal Arts & Humanities Nursing Science & Math Social Science Trade & Technical We will collect your contact information to respond to your requests for information and provide you with educational matching services. As a result, you may be matched to one or more sponsored schools from which we receive compensation. Compensation may impact where Sponsored Schools appear on our websites. We use cookies and other tracking technologies to collect your personal information in order to gauge online activity on our website, measure the effectiveness of online services, applications, and tools. For more information, see our privacy policy. What is the highest level of education you have achieved? No High School Diploma High School Diploma GED Some College (1-29 credits) Some College (30-59 credits) Some College (60+ credits) Associates Degree Masters Degree Doctorates/PhD Bachelors Degree What year did you obtain your high school diploma or GED? Select Option 19601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024 Do you have a current, unrestricted RN, LPN, or LVN license? Select Option YesNo [select] Teaching License (hide and default to NO) Select Option YesNo [select] Enrolled in College (hide and default to NO) Select Option YesNo BACK BACK What year were you born? Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 20062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924 Are you a U.S. Citizen? Yes No Please select your military status: No Military Affiliation AF - Active Duty (AD) AF - Selective Reserve (SR) AF - Spouse of AD or SR AF - Veteran AF - Civilian AR - Active Duty (AD) AR - Selective Reserve (SR) AR - Spouse of AD or SR AR - Veteran AR - Civilian CG - Active Duty (AD) CG - Selective Reserve (SR) CG - Spouse of AD or SR CG - Veteran CG - Civilian MC - Active Duty (AD) MC - Selective Reserve (SR) MC - Spouse of AD or SR MC - Veteran MC - Civilian NV - Active Duty (AD) NV - Selective Reserve (SR) NV - Spouse of AD or SR NV - Veteran NV - Civilian BACK When would you like to start: Immediately 1-3 Months 4-6 Months 7-12 Months More than 1 Year Not Sure Best Time to Contact Anytime Morning Afternoon Evening On a scale of 1 to 10 with 10 being the highest, how motivated are you to enroll in school? Select Option 12345678910 Do you own a PC with unrestricted reliable internet access? Yes No Do you prefer online or campus? Select Option OnlineCampusBoth BACK What is your gender? Male Female First Name Last Name Mobile Phone E-mail BACK Address Address 2 City State Select State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code By checking this box, you give your consent to be contacted on behalf of ChooseYourEducation.com and any selected schools by email and/or at the telephone number(s) provided with automated technology, pre-recorded messages, and/or pre-recorded voices, including your wireless number if provided. This consent is not required as a condition to purchase a good or services. Msg and data rates may apply. To opt-out of having your personal information collected, click here. BACK Continue FEATURED ARTICLES: A THREE-PART PLAN PROMISES TO CANCEL $10,000 OF STUDENT DEBT TEACHING AND LEARNING AFTER COVID-19 GOING BACK TO SCHOOL AS AN ADULT IN 5 EASY STEPS FACING YOUR FEARS OF RETURNING TO SCHOOL AS AN ADULT SPONSORED MEANING EXPLAINED ChooseYourEducation.com receives compensation for the featured schools on our websites (see 'Sponsored Schools' or 'Sponsored Listings' or 'Sponsored Results'). So what does this mean for you? Compensation may impact where the Sponsored Schools appear on our websites, including whether they appear as a match through our education matching services tool, the order in which they appear in a listing, and/or their ranking. Okay 5 East Main St. Suite 24B, Denville, NJ 07834 USEFUL LINKS * Disclosure * FAQ * Privacy Policy * About Us * Unsubscribe * Do Not Sell My Information FOLLOW US ©2024 ChooseYourEducation. All logos are property of their respective owners.