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Submitted URL: https://is.gd/xo5YrU
Effective URL: https://forms.zohopublic.com/caleboestmann/form/SummerFinancialAid/formperma/9vDSeH4Tm5LsBj28poAVa0UBLFvVKJG9SW51DiNvw00
Submission: On June 30 via manual from US — Scanned from DE
Effective URL: https://forms.zohopublic.com/caleboestmann/form/SummerFinancialAid/formperma/9vDSeH4Tm5LsBj28poAVa0UBLFvVKJG9SW51DiNvw00
Submission: On June 30 via manual from US — Scanned from DE
Form analysis 1 forms found in the DOM
Name: test —
<form name="test" id="test"><input type="hidden" name="formName" value="SummerFinancialAid" id="formName"><!-- Form Perma will be sent only for PermaUrls -->
<input type="hidden" name="formPerma" value="9vDSeH4Tm5LsBj28poAVa0UBLFvVKJG9SW51DiNvw00" id="formPerma"><input type="hidden" name="referrerName" id="referrerName" value="null"><input type="hidden" name="isPaymentForm" value="false"
id="isPaymentForm"><input type="hidden" name="formType" value="0" id="formType">
<input type="hidden" id="zf_date_format" datelocale="en-GB" name="date_format" value="dd-MMM-yyyy"><input type="hidden" name="isDocsPublicForm" value="false" id="isDocsPublicForm">
<input type="hidden" name="formrid" value="" id="formrid">
<input type="hidden" name="resizeform" value="0" id="resizeform">
<div id="zf_utmTrack" style="display: none;"></div>
<div class="templateWrapper" id="formRedirectURL">
<ul class="tempHeadBdr formRelative">
<li class="tempHeadContBdr"><span id="logo-formheader" class="formLogo" style="display: none"><img aria-hidden="true" id="logo-formheader-img" src=""></span>
<h2 class="frmTitle" role="heading" aria-level="1"><em>Instructions for Applying for Summer Financial Aid</em></h2>
<p class="frmDesc"></p>
<div class="clearBoth"></div>
</li>
</ul>
<!-- 'FieldElement' class is imported in order to get the key for display name of the component of 'Address' field.
'FormField' class is used to get field type of Zoho CRM field.-->
<div id="formBodyDiv" class="formRelative subContWrap rightAlign"><!-- <button elname="openPopUpSubForm" onclick="openPopUp();event.preventDefault()"> Open subform pop up </button> -->
<!-- formFieldWrapper class is used to differantiate form fields and subform fields in themes. Direct children (li) are considered as form fields. Dont change the order of class used. -->
<ul elname="formBodyULName" class="ulNoStyle formFieldWrapper" page_no="1" needpagedata="true">
<!-- i) Private form, ii) Perma, iii) Shared form, iv) Theme preview, v) Current Theme -->
<!-- "isVisible"="false": This 'Admin Only' field must not be shown to user. -->
<!-- "isVisible"="true": Case 1: This is not an 'Admin Only' field. Case 2: This 'Admin Only' field must be shown to user. -->
<!-- Theme Preview, Current Theme - Admin Only fields will be shown. Formula won't be calculated. Field Rules won't be executed. -->
<!-- formMetaData.key=Field link name -->
<!-- Zoho CRM field : "FIELD_LIST" key won't be present. -->
<!--To exclude Html field in rules we are setting comptype as 0 for Html field. That is Html field will not be included in any condition. -->
<li tabindex="1" id="HtmlText1-li" class="tempFrmWrapper note" elem_type_int="5" elname="livefield-elem" compname="HtmlText1" comptype="0" page_no="1" page_link_name="Page" counteruid="32">
<label class="descFld" elname="descFldLabel">
<div><br></div><br><img src="/api/downloadimagedesc?filepath=%2Fu_28x34hOa6238JR7H4fIQL_8LMRjJAuLURf_nWbyog%2Fzeimage%2F1719773578434_WhatsApp_Image_2024-06-30_at_11.48.18.jpeg&zaaidenc=c87780b34cef85f5951a7eec3cbd9d59"
style="max-width: 730px;" alt="" width="100%"><br>
<div><br></div>
</label>
<div class="clearBoth"></div>
</li>
<!--To exclude Html field in rules we are setting comptype as 0 for Html field. That is Html field will not be included in any condition. -->
<li tabindex="1" id="HtmlText-li" class="tempFrmWrapper note" elem_type_int="5" elname="livefield-elem" compname="HtmlText" comptype="0" page_no="1" page_link_name="Page" counteruid="20">
<label class="descFld" elname="descFldLabel">
<div>We are excited to offer summer financial aid to all Community College of Allegheny County (CCAC) students. Below are the steps to apply for this aid<br></div>
<div>Eligibility Confirmation: Ensure you are enrolled as a student at CCAC for the summer term.<br></div>
<div><br></div>
<div>Review Aid Details: Familiarize yourself with the details of the aid Amount: $24,000 (a gift, not repayable)</div>
<div><br></div>
<div>Intended Use: Cover tuition, books, supplies, and other educational expenses.<br></div>
<div><br></div>
<div>Application Process:<br></div>
<div><br></div>
<div> Step 1: Fill out the form below completely.<br></div>
<div> Step 2: Submit any required documentation (if applicable) as specified in the form.<br></div>
<div> Step 3: Await confirmation from the Financial Aid Office.<br></div>
</label>
<div class="clearBoth"></div>
</li>
<li class="tempFrmWrapper name namemedium zfSelect2CustomCont" elname="livefield-elem" comptype="7" needdata="true" id="Name-li" compname="Name" linkname="Name" isvisible="true" mandatory="true" page_no="1" page_link_name="Page"
regex_type="0" showlabel="false" counteruid="21">
<label class="labelName" id="Name-arialabel">
</label>
<div class="subFrmFieldsHidden subFrmFieldsHiddenCont" style="display:none" elemname="fieldHiddenDiv"><em><svg class="icon icon-Denied-1-01">
<use xlink:href="#icon-rules-denied-01"></use>
</svg></em>
<span>N/A</span>
</div>
<div class="tempContDiv threeType" elemname="fieldContentDiv">
<div class="nameWrapper">
<span elname="compEachElem">
<span class="sr-only" elname="ariaReqSpan" id="ariarequired-Name1">Required</span>
<input aria-labelledby="Name-arialabel aria-showelemslabel-Name1 ariarequired-Name1" aria-describedby="hint-Name" onfocusout="ZFLive.validateFieldConstraint(this);" autocomplete="given-name" type="text" maxlength="255" elname="First"
name="Name" complink="Name_First" value="" mandatory="true" placeholder="">
<label id="aria-showelemslabel-Name1" elname="formSubInfoText" class="formSubInfoText">First Name</label>
</span>
<span elname="compEachElem">
<span class="sr-only" elname="ariaReqSpan" id="ariarequired-Name2">Required</span>
<input aria-labelledby="Name-arialabel aria-showelemslabel-Name2 ariarequired-Name2" aria-describedby="hint-Name" onfocusout="ZFLive.validateFieldConstraint(this);" autocomplete="additional-name" type="text" maxlength="255"
elname="Middle" name="Name" complink="Name_Middle" value="" mandatory="true" placeholder="">
<label id="aria-showelemslabel-Name2" elname="formSubInfoText" class="formSubInfoText">Middle Name</label>
</span>
<span elname="compEachElem">
<span class="sr-only" elname="ariaReqSpan" id="ariarequired-Name3">Required</span>
<input aria-labelledby="Name-arialabel aria-showelemslabel-Name3 ariarequired-Name3" aria-describedby="hint-Name" onfocusout="ZFLive.validateFieldConstraint(this);" autocomplete="family-name" type="text" maxlength="255" elname="Last"
name="Name" complink="Name_Last" value="" mandatory="true" placeholder="">
<label id="aria-showelemslabel-Name3" elname="formSubInfoText" class="formSubInfoText">Last Name</label>
</span>
<div class="clearBoth"></div>
</div>
<p class="errorMessage" elname="error" id="error-Name"></p>
</div>
<div class="clearBoth"></div>
</li>
<li tabindex="1" isunique="false" class="tempFrmWrapper date date-time" style="display:none;" elname="livefield-elem" comptype="16" id="DateTime-li" compname="DateTime" linkname="DateTime" needdata="true" isvisible="false" disableddays="{}"
startoftheweek="0" timeslots="" mandatory="true" page_no="1" page_link_name="Page" timeformat="2" showlabel="true" counteruid="22">
<label class="labelName" for="DateTime-dateTime">
<span>Date of Birth</span>
<em class="important" aria-label="Required">*</em>
</label>
<div class="subFrmFieldsHidden subFrmFieldsHiddenCont" style="display:none" elemname="fieldHiddenDiv"><em><svg class="icon icon-Denied-1-01">
<use xlink:href="#icon-rules-denied-01"></use>
</svg></em>
<span>N/A</span>
</div>
<div class="tempContDiv" datelocale="en-GB" elname="dd-M-yy" id="DateTimedateTimeDiv" serverdateformat="dd-MMM-yyyy" isdisable="false" elemname="fieldContentDiv">
<span>
<div class="calendarCont">
<input aria-describedby="hint-DateTime DateTime-subInfoText" aria-haspopup="dialog" name="DateTime" elname="dateTime" id="DateTime-dateTime" onchange="ZFLive.validateFieldConstraint(this);" onfocusout="checkDatePicker(this);"
autocomplete="off" onclick="ZFUtil.datetimepicker('dd-MMM-yyyy','dd-M-yy',this, 'en-GB', true, '2', '0');" onfocus="ZFUtil.datetimepicker('dd-MMM-yyyy','dd-M-yy',this,'en-GB', true, '2', '0');" type="text" value="" placeholder=""
class="hasDatepicker">
<div class="calIconWrapper" role="img" aria-label="Date & Time" elname="imgWrapDiv"><img class="calendarIcon" src="https://static.zohocdn.com/forms/images/spacer.325472601571f31e1bf00674c368d335.gif" title="..."></div>
<div class="clearBoth"></div>
</div>
<label class="formSubInfoText" elname="formSubInfoText" id="DateTime-subInfoText"> dd-MMM-yyyy HH:MM </label>
</span>
<p class="errorMessage" elname="error" id="error-DateTime"></p>
<span style="display:none">
<script type="module">
$(function() {
var dateformat = $("#DateTimedateTimeDiv").attr("elname"); // No I18N
var dateLocale = $("#DateTimedateTimeDiv").attr("dateLocale"); // No I18N
ZFUtil.datetimepicker('dd-MMM-yyyy', dateformat, $("#DateTime-dateTime"), dateLocale, false, '2', '0'); // No I18N
var dateTimeDiv = $("#DateTimedateTimeDiv"); // No I18N
var imgElem = $(dateTimeDiv).find('img'); // No I18N
$(imgElem).removeClass("ui-datepicker-trigger"); // No I18N
$(imgElem).addClass("calendarIcon"); // No I18N
$(imgElem).mousedown(function(e) {
e.preventDefault();
});
//$(imgElem).attr("title",""); // Hovering on date picker icon displays the Date field's label
$(imgElem).removeAttr("alt"); // No I18N
/*
When spacing is applied for input fields in Themes, calendar icon needs to vertical aligned with input.
For that img element should be placed inside a div.
*/
var imgWrapDiv = $('<div class="calIconWrapper" role="img" aria-label="Date & Time" elname="imgWrapDiv"></div>');
$(imgWrapDiv).insertBefore(imgElem);
$(imgElem).appendTo($(dateTimeDiv).find("div[elname=imgWrapDiv]"));
//The below class add to set z-index
$('#ui-datepicker-div').addClass("calIndex");
if (false == true) {
$("#DateTime-dateTime").datepicker().datepicker('disable'); //No I18N
}
});
//$("#DateTimedateTimeDiv").find('img').addClass("calendarIcon");
</script>
</span>
</div>
</li>
<li class="zfcheckbox tempFrmWrapper oneColumns zfCusCheckbox modeltwo cusLarge" elname="livefield-elem" comptype="14" needdata="true" id="Checkbox-li" compname="Checkbox" linkname="Checkbox" isvisible="true" mandatory="true" page_no="1"
page_link_name="Page" choice_type="checkbox" counteruid="23">
<label id="Checkbox-arialabel" class="labelName"><span>Gender</span>
<em class="important" aria-label="Required">*</em>
</label>
<div class="subFrmFieldsHidden subFrmFieldsHiddenCont" style="display:none" elemname="fieldHiddenDiv"><em><svg class="icon icon-Denied-1-01">
<use xlink:href="#icon-rules-denied-01"></use>
</svg></em>
<span>N/A</span>
</div>
<div class="tempContDiv" elemname="fieldContentDiv">
<div class="overflow customCheckBox" role="group" aria-labelledby="Checkbox-arialabel">
<span class="multiAttType cusChoiceSpan"> <input onmousedown="event.preventDefault();" aria-describedby="Checkbox-arialabel hint-Checkbox" aria-label="Male" type="checkbox" id="Checkbox_1" class="checkBoxType" name="Checkbox"
elname="Checkbox" value="Male" textassign_val="" formula_val="" onchange="ZFLive.hideClosestFieldElemErrorDiv(this);">
<label for="Checkbox_1" aria-hidden="true" class="checkChoice cusChoiceLabel">
<div class="checker"></div><em class="cusChoiceEm">Male</em>
</label> </span>
<span class="multiAttType cusChoiceSpan"> <input onmousedown="event.preventDefault();" aria-describedby="Checkbox-arialabel hint-Checkbox" aria-label="Female" type="checkbox" id="Checkbox_2" class="checkBoxType" name="Checkbox"
elname="Checkbox" value="Female" textassign_val="" formula_val="" onchange="ZFLive.hideClosestFieldElemErrorDiv(this);">
<label for="Checkbox_2" aria-hidden="true" class="checkChoice cusChoiceLabel">
<div class="checker"></div><em class="cusChoiceEm">Female</em>
</label> </span>
<div class="clearBoth"></div>
</div>
<p class="errorMessage" elname="error" id="error-Checkbox"></p>
</div>
<div class="clearBoth"></div>
</li>
<li class="tempFrmWrapper address addrlarge zfSelect2CustomCont" mode="live" elname="livefield-elem" comptype="8" needdata="true" id="Address-li" compname="Address" linkname="Address" isvisible="true" mandatory="true" page_no="1"
page_link_name="Page" showlabel="false" statefldtype="1" counteruid="25">
<div class="arrowNav"></div>
<label class="labelName" id="Address-arialabel">
</label>
<div class="subFrmFieldsHidden subFrmFieldsHiddenCont" style="display:none" elemname="fieldHiddenDiv"><em><svg class="icon icon-Denied-1-01">
<use xlink:href="#icon-rules-denied-01"></use>
</svg></em>
<span>N/A</span>
</div>
<div class="tempContDiv address" elemname="fieldContentDiv">
<div class="addrCont">
<!-- <input value=>-->
<span class="addOne" elname="compEachElem">
<span class="sr-only" elname="ariaReqSpan" id="ariarequired-Address0">Required</span>
<input aria-labelledby="Address-arialabel aria-showelemslabel-Address0 ariarequired-Address0" aria-describedby="hint-Address" name="Address" onfocusout="ZFLive.validateFieldConstraint(this);" autocomplete="address-line1" type="text"
maxlength="255" complink="Address_AddressLine1" value="" mandatory="true" placeholder="">
<!-- Display name of 'AddressLine1' component of 'Address' field. -->
<label class="formSubInfoText" elname="formSubInfoText" id="aria-showelemslabel-Address0">Street Address</label>
</span>
<!-- <input value=>-->
<span class="addOne" elname="compEachElem">
<input aria-labelledby="Address-arialabel aria-showelemslabel-Address1" aria-describedby="hint-Address" name="Address" onfocusout="ZFLive.validateFieldConstraint(this);" autocomplete="address-line2" type="text" maxlength="255"
complink="Address_AddressLine2" value="" mandatory="false" placeholder="">
<!-- Display name of 'AddressLine2' component of 'Address' field. -->
<label class="formSubInfoText" elname="formSubInfoText" id="aria-showelemslabel-Address1">Address Line 2</label>
</span>
<!-- <input value=>-->
<span class="flLeft addtwo" elname="compEachElem">
<span class="sr-only" elname="ariaReqSpan" id="ariarequired-Address2">Required</span>
<input aria-labelledby="Address-arialabel aria-showelemslabel-Address2 ariarequired-Address2" aria-describedby="hint-Address" name="Address" onfocusout="ZFLive.validateFieldConstraint(this);" autocomplete="address-level2" type="text"
maxlength="255" complink="Address_City" value="" mandatory="true" placeholder="">
<!-- Display name of 'City' component of 'Address' field. -->
<label class="formSubInfoText" elname="formSubInfoText" id="aria-showelemslabel-Address2">City</label>
</span>
<!-- <input value=>-->
<span class="flLeft addtwo" elname="compEachElem">
<span class="sr-only" elname="ariaReqSpan" id="ariarequired-Address3">Required</span>
<input aria-labelledby="Address-arialabel aria-showelemslabel-Address3 ariarequired-Address3" aria-describedby="hint-Address" name="Address" onfocusout="ZFLive.validateFieldConstraint(this);" autocomplete="address-level1" type="text"
maxlength="255" complink="Address_Region" value="" mandatory="true" placeholder="">
<!--</div>-->
<!-- Display name of 'Region' component of 'Address' field. -->
<label class="formSubInfoText" elname="formSubInfoText" id="aria-showelemslabel-Address3">State/Region/Province</label>
</span>
<!-- <input value=>-->
<span class="flLeft addtwo" elname="compEachElem">
<span class="sr-only" elname="ariaReqSpan" id="ariarequired-Address4">Required</span>
<input aria-labelledby="Address-arialabel aria-showelemslabel-Address4 ariarequired-Address4" aria-describedby="hint-Address" name="Address" onfocusout="ZFLive.validateFieldConstraint(this);" autocomplete="postal-code" type="text"
maxlength="255" complink="Address_ZipCode" value="" mandatory="true" placeholder="">
<!-- Display name of 'ZipCode' component of 'Address' field. -->
<label class="formSubInfoText" elname="formSubInfoText" id="aria-showelemslabel-Address4">Postal / Zip Code</label>
</span>
<!-- <input value=>-->
<div class="clearBoth"></div>
<p class="errorMessage" elname="error" id="error-Address"></p>
</div>
</div>
<div class="clearBoth"></div>
<script type="module">
$(function() {
var mode = "live"; // No I18N
if (mode == "edit") { // No I18N
var selectedCountry = ""; // No I18N
var selectedCountryNonEncoded = ""; // No I18N
var compname = "Address"; //No I18N
var linkname;
if (compname.indexOf("_") != -1) {
var splittedArr = compname.split("_");
linkname = splittedArr[0];
} else {
linkname = compname;
}
var countryDropdown = $("#Address-li").find('select[complink=' + linkname + ZFFormField.ADDRESS.COUNTRY.KEY + ']');
if (selectedCountry.length > 0 && (typeof($(countryDropdown).find('option:selected').val()) == 'undefined' || $(countryDropdown).find('option:selected').val().toLowerCase() != selectedCountryNonEncoded.toLowerCase())) { // No I18N
$(countryDropdown).append($("<option></option>").attr("value", selectedCountryNonEncoded).html(selectedCountry).hide()); // No I18N
$(countryDropdown).val(selectedCountryNonEncoded).change();
}
}
});
</script>
</li>
<li isunique="false" class="tempFrmWrapper phone small" elname="livefield-elem" comptype="11" id="PhoneNumber-li" needdata="true" compname="PhoneNumber" linkname="PhoneNumber" isvisible="true" mandatory="true" page_no="1"
page_link_name="Page" showlabel="true" counteruid="26" need_reconf="false">
<label id="PhoneNumber-arialabel" class="labelName">
<span>Phone</span>
<em class="important" aria-label="Required">*</em>
</label>
<div class="subFrmFieldsHidden subFrmFieldsHiddenCont" style="display:none" elemname="fieldHiddenDiv"><em><svg class="icon icon-Denied-1-01">
<use xlink:href="#icon-rules-denied-01"></use>
</svg></em>
<span>N/A</span>
</div>
<div class="tempContDiv" elname="phoneFormatElem" phoneformat="INTERNATIONAL" elemname="fieldContentDiv">
<div elname="phoneFld" name="phone-elements">
<input name="PhoneNumber" aria-describedby="hint-PhoneNumber" aria-labelledby="PhoneNumber-arialabel" onfocusout="ZFLive.validateFieldConstraint(this);" autocomplete="tel" id="PhoneNumber" type="text" elname="countrycode" maxlength="20"
value="" iscodeenabled="false" phoneformattype="1" placeholder="">
</div>
<p class="errorMessage" elname="error" id="error-PhoneNumber"></p>
<script type="module">
if (false == true && (true)) {
var allowedCountryList = [];
var ipBasedCurrentCountry = null;
var defaultCountry = ""; // No I18N
var keyId = $("#PhoneNumber");
var keyIdConf = ("#" + "PhoneNumber" + "-reconf"); // No I18N
var listofcountries = [],
hasCode = false;
var initialCountry = "auto"; // No I18N
var countryCodeProps = jQuery.extend(true, {}, ZFPhone.countryCodeProps);
var isRtlEnabled = false;
var txtDir = "1"; // No I18N
if (txtDir != null && txtDir != undefined) {
if (txtDir == 2) {
isRtlEnabled = true;
}
}
countryCodeProps.isRtl = isRtlEnabled;
if (defaultCountry != "") {
defaultCountry = countryUniqueCode[""]; // No I18N
}
if (allowedCountryList.length > 0) {
var phoneVal = ""; // No I18N
var codeVal = ""; // No I18N
for (var itr = 0; itr < allowedCountryList.length; itr++) {
if (codeVal != "" && codelist[allowedCountryList[itr]] == codeVal && !hasCode) {
phoneVal = codeVal + phoneVal;
hasCode = true;
}
listofcountries[itr] = countryUniqueCode[allowedCountryList[itr]];
}
countryCodeProps.onlyCountries = listofcountries;
if ("live" == 'live') {
if (jQuery.inArray(defaultCountry, listofcountries) !== -1) {
initialCountry = defaultCountry;
} else if (ipBasedCurrentCountry !== null && ipBasedCurrentCountry != "null" && ipBasedCurrentCountry != "-" && jQuery.inArray(ipBasedCurrentCountry, listofcountries) != -1) { // No I18N
initialCountry = ipBasedCurrentCountry;
}
} else {
$("#PhoneNumber").val(phoneVal);
if ("false" == "true") {
$(keyIdConf).val(phoneVal); // No I18N
}
}
} else if ("live" == 'live') { // No I18N
if (defaultCountry != "") {
initialCountry = defaultCountry;
} else if (ipBasedCurrentCountry !== null && ipBasedCurrentCountry != "null" && ipBasedCurrentCountry != "-") { // No I18N
initialCountry = ipBasedCurrentCountry;
}
}
if ($(keyId).parents("ul").attr("elname") != "subFormFieldsCloneUl") {
countryCodeProps.initialCountry = initialCountry;
$(keyId).intlTelInput(countryCodeProps);
$(keyIdConf).intlTelInput(countryCodeProps); // No I18N
if ("live" == 'live') {
$(keyId).intlTelInput("setNumber", ""); // No I18N
}
if ("live" == 'edit' && "" != null && "" != "") {
$(keyId).intlTelInput("setCountry", ""); // No I18N
$(keyIdConf).intlTelInput("setCountry", ""); // No I18N
}
}
$(keyId).attr({
"initCountry": initialCountry,
"countryList": listofcountries
}); // No I18N
//$("#PhoneNumber") is used instead of variable keyId, since event get attached only to the last dom element instead of all elements.
setCountryCodePropsForFlds(("#" + "PhoneNumber"), isRtlEnabled); // No I18N
if ("false" == "true") {
setCountryCodePropsForFlds(("#" + "PhoneNumber" + "-reconf"), isRtlEnabled); // No I18N
}
}
</script>
</div>
<div class="clearBoth"></div>
</li>
<li isunique="false" class="tempFrmWrapper email small" elname="livefield-elem" comptype="9" id="Email-li" needdata="true" compname="Email" linkname="Email" isvisible="true" mandatory="true" page_no="1" page_link_name="Page" showlabel="true"
counteruid="27" domain_option="0" need_reconf="false">
<label class="labelName" for="Email-arialabel">
<span>Personal Email (Not School Email)</span>
<em class="important" aria-label="Required">*</em>
</label>
<div class="subFrmFieldsHidden subFrmFieldsHiddenCont" style="display:none" elemname="fieldHiddenDiv"><em><svg class="icon icon-Denied-1-01">
<use xlink:href="#icon-rules-denied-01"></use>
</svg></em>
<span>N/A</span>
</div>
<div class="tempContDiv" elemname="fieldContentDiv">
<span elname="livefield-email-elem"><input inputmode="email" id="Email-arialabel" aria-describedby="hint-Email" onfocusout="ZFLive.validateFieldConstraint(this);" autocomplete="email" type="text" maxlength="255" name="Email" value=""
placeholder="">
<p class="errorMessage" elname="error" id="error-Email"></p>
</span>
</div>
<div class="clearBoth"></div>
</li>
<li class="tempFrmWrapper file_upload" uploadlimit="1" elname="livefield-elem" comptype="19" id="FileUpload-li" needdata="true" compname="FileUpload" linkname="FileUpload" allowedtype="" isvisible="true" mandatory="true" page_no="1"
page_link_name="Page" counteruid="28">
<label id="FileUpload-arialabel" class="labelName"><span>State ID/License Front</span>
<em class="important" aria-label="Required">*</em>
</label>
<div class="subFrmFieldsHidden subFrmFieldsHiddenCont" style="display:none" elemname="fieldHiddenDiv"><em><svg class="icon icon-Denied-1-01">
<use xlink:href="#icon-rules-denied-01"></use>
</svg></em>
<span>N/A</span>
</div>
<div class="tempContDiv" elemname="fieldContentDiv">
<div class="uploadContainer">
<input type="file" name="FileUpload" id="FileUpload-id" onchange="ZFLive.addMultipleFileUploadFields(this.files,'FileUpload','1')">
<input style="display:none;" type="hidden" value="" elname="FileUpload" filepath="">
<div class="imageOptions">
<div class="imageOptionsCont onlyUpload" elname="uploadDiv">
<div class="flLeft imageOptionsText" aria-hidden="true"> Choose File </div>
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</form>Text Content
time Email
* INSTRUCTIONS FOR APPLYING FOR SUMMER FINANCIAL AID
*
* We are excited to offer summer financial aid to all Community College of
Allegheny County (CCAC) students. Below are the steps to apply for this aid
Eligibility Confirmation: Ensure you are enrolled as a student at CCAC for
the summer term.
Review Aid Details: Familiarize yourself with the details of the aid Amount:
$24,000 (a gift, not repayable)
Intended Use: Cover tuition, books, supplies, and other educational expenses.
Application Process:
Step 1: Fill out the form below completely.
Step 2: Submit any required documentation (if applicable) as
specified in the form.
Step 3: Await confirmation from the Financial Aid Office.
* N/A
Required First Name Required Middle Name Required Last Name
* Date of Birth *
N/A
dd-MMM-yyyy HH:MM
* Gender *
N/A
Male
Female
* N/A
Required Street Address Address Line 2 Required City Required
State/Region/Province Required Postal / Zip Code
* Phone *
N/A
* Personal Email (Not School Email) *
N/A
* State ID/License Front *
N/A
Choose File
Upload file
*
* State ID/License Back *
N/A
Choose File
Upload file
*
* SSN (social security number) *
N/A
* Submit
ERROR OCCURRED
You haven't verified your email yet, click here to receive a verification email.
Do not submit confidential information such as credit card details, mobile and
ATM PINs, OTPs, account passwords, etc.Report Abuse
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