{"id":1222,"date":"2022-07-18T10:52:25","date_gmt":"2022-07-18T14:52:25","guid":{"rendered":"https:\/\/www.ramapo.edu\/ccec\/?page_id=1222"},"modified":"2026-06-09T10:40:57","modified_gmt":"2026-06-09T14:40:57","slug":"we-care-program-application","status":"publish","type":"page","link":"https:\/\/www.ramapo.edu\/ccec\/we-care-program-application\/","title":{"rendered":"We Care Program Application"},"content":{"rendered":"<p><span style=\"font-weight: 400\">The We Care Program is a campus-wide initiative, overseen by the Center for Student Involvement The We Care Program at 缅北重口 is comprised of:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Food Pantry<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Laptop Upcycle<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Professional Clothing Closet<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Student Relief Fund<\/span><\/li>\n<li>Valley Health Fund<\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">For additional information about each individual program, please see the <\/span><a href=\"https:\/\/www.ramapo.edu\/ccec\/we-care-program\/\"><span style=\"font-weight: 400\">We Care Program<\/span><\/a><span style=\"font-weight: 400\"> home page<\/span><\/p>\n<p><span style=\"font-weight: 400\">In order to be considered for assistance, please submit this application. By submitting this application, you are granting professional staff members and Social Work Interns permission to review your financial aid, academic, and judicial standing. We may also reach out to other departments and areas to assess available resources.<\/span><\/p>\n<p><span style=\"font-weight: 400\">To be eligible for assistance, students must be currently enrolled and in good judicial standing.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Following the completion of this application, a representative from the We Care program will reach out to set up an appointment to complete an intake. All communications regarding your application will be conducted through your Ramapo email address. If you have any questions or concerns, please email wecare@ramapo.ed<\/span><\/p>\n<hr \/>\n\t\t<script type=\"text\/javascript\">\n\t\t\tjQuery(document).ready(function(){\n\t\t\t\tvar prmstr = window.location.search.substr(1);\n\t\t\t\tvar prmarr = prmstr.split (\"&\");\n\n\t\t\t\tfor ( var i = 0; i < prmarr.length; i++)\n\t\t\t\t{\n\t\t\t\t\tvar tmparr = prmarr[i].split(\"=\");\n\t\t\t\t\tvar origVal = decodeURIComponent(tmparr[1]);\n\t\t\t\t\tvar modifier = origVal.substr(0,1);\n\t\t\t\t\tvar theField = jQuery(\"#\"+tmparr[0]);\n\t\t\t\t\tif(modifier == '^')\n\t\t\t\t\t{\n\t\t\t\t\t\tvalue = origVal.substr(1);\n\t\t\t\t\t\ttheField.attr('readonly','readonly');\n\t\t\t\t\t}\n\t\t\t\t\telse\n\t\t\t\t\t{\n\t\t\t\t\t\tvalue = origVal;\n\t\t\t\t\t}\n\t\t\t\t\ttheField.val(value);\n\t\t\t\t}\n\t\t\t});\n\t\t<\/script>\n\t\t<link rel='stylesheet' id='formidable-css' href='https:\/\/www.ramapo.edu\/ccec\/wp-admin\/admin-ajax.php?action=frmpro_css&#038;ver=3131655' type='text\/css' media='all' \/>\n<div class=\"frm_forms  with_frm_style frm_style_formidable-style\" id=\"frm_form_12_container\" >\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_pro_form \" id=\"form_if7jk2\" >\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_hidden\">We Care Application Form<\/legend>\r\n<h3 class=\"frm_form_title\">We Care Application Form<\/h3>\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"12\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_12\" id=\"frm_hide_fields_12\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"if7jk2\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_12\" name=\"frm_submit_entry_12\" value=\"49434276a5\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/ccec\/wp-json\/wp\/v2\/pages\/1222\" \/><div id=\"frm_field_545_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm6 frm12 frm_first\">\r\n    <label class=\"frm_primary_label\" for=\"field_24eng2\">First Name\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_24eng2\" name=\"item_meta[545]\" value=\"\"  data-reqmsg=\"First Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"First Name is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_546_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label class=\"frm_primary_label\" for=\"field_j66zt2\">Last Name\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_j66zt2\" name=\"item_meta[546]\" value=\"\"  data-reqmsg=\"Last Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Last Name is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_547_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label class=\"frm_primary_label\" for=\"field_8l8uy2\">R#\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_8l8uy2\" name=\"item_meta[547]\" value=\"\"  data-reqmsg=\"R# cannot be blank.\" aria-required=\"true\" data-invmsg=\"R# is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_548_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label class=\"frm_primary_label\" for=\"field_4enl12\">缅北重口 Email\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_4enl12\" name=\"item_meta[548]\" value=\"\"  data-reqmsg=\"缅北重口 Email cannot be blank.\" aria-required=\"true\" data-invmsg=\"缅北重口 Email is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_549_container\" class=\"frm_form_field form-field  frm_top_container frm12 frm_first\">\r\n    <label id=\"field_nfis82_label\" class=\"frm_primary_label\" for=\"field_nfis82\">Secondary Email\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_nfis82\" name=\"item_meta[549]\" value=\"\"  data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_550_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label class=\"frm_primary_label\" for=\"field_xr4y52\">Preferred Phone Number\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_xr4y52\" name=\"item_meta[550]\" value=\"\"  data-invmsg=\"Preferred Phone Number is invalid\" aria-invalid=\"false\" pattern=\"((\\+\\d{1,3}(-|.| )?\\(?\\d\\)?(-| |.)?\\d{1,5})|(\\(?\\d{2,6}\\)?))(-|.| )?(\\d{3,4})(-|.| )?(\\d{4})(( x| ext)\\d{1,5}){0,1}$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_551_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <div id=\"field_jqcdy2_label\" class=\"frm_primary_label\" for=\"field_jqcdy2\">What is your current mailing address?\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/div>\r\n    <fieldset aria-labelledby=\"field_jqcdy2_label\">\n<legend class=\"frm_screen_reader frm_hidden\">\n\tWhat is your current mailing address?<\/legend>\n<div class=\"frm_combo_inputs_container\">\n<div id=\"frm_field_551-line1_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_jqcdy2_line1\" class=\"frm_screen_reader frm_hidden\">\n\t\tWhat is your current mailing address?\t<\/label>\n\t\t<input type=\"text\" id=\"field_jqcdy2_line1\" value=\"\" name=\"item_meta[551][line1]\"  data-reqmsg=\"What is your current mailing address? cannot be blank.\" aria-required=\"true\" data-invmsg=\"What is your current mailing address? is invalid\" aria-invalid=\"false\"   autocomplete=\"address-line1\" \/>\n\t<\/div>\n<div id=\"frm_field_551-line2_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_jqcdy2_line2\" class=\"frm_screen_reader frm_hidden\">\n\t\tWhat is your current mailing address?\t<\/label>\n\t\t<input type=\"text\" id=\"field_jqcdy2_line2\" value=\"\" name=\"item_meta[551][line2]\"  data-reqmsg=\"What is your current mailing address? cannot be blank.\" aria-required=\"true\" data-invmsg=\"What is your current mailing address? is invalid\" class=\"frm_optional\" aria-invalid=\"false\"   autocomplete=\"address-line2\" \/>\n\t<\/div>\n<div id=\"frm_field_551-city_container\" class=\"frm_form_field form-field frm_third frm_first\">\n\t<label for=\"field_jqcdy2_city\" class=\"frm_screen_reader frm_hidden\">\n\t\tCity\t<\/label>\n\t\t<input type=\"text\" id=\"field_jqcdy2_city\" value=\"\" name=\"item_meta[551][city]\"  data-reqmsg=\"What is your current mailing address? cannot be blank.\" aria-required=\"true\" data-invmsg=\"What is your current mailing address? is invalid\" aria-invalid=\"false\"   autocomplete=\"address-level2\" \/>\n\t<div class=\"frm_description\">City<\/div><\/div>\n<div id=\"frm_field_551-state_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_jqcdy2_state\" class=\"frm_screen_reader frm_hidden\">\n\t\tState\/Province\t<\/label>\n\t\t<input type=\"text\" id=\"field_jqcdy2_state\" value=\"\" name=\"item_meta[551][state]\"  data-reqmsg=\"What is your current mailing address? cannot be blank.\" aria-required=\"true\" data-invmsg=\"What is your current mailing address? is invalid\" aria-invalid=\"false\"   autocomplete=\"address-level1\" \/>\n\t<div class=\"frm_description\">State\/Province<\/div><\/div>\n<div id=\"frm_field_551-zip_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_jqcdy2_zip\" class=\"frm_screen_reader frm_hidden\">\n\t\tZip\/Postal\t<\/label>\n\t\t<input type=\"text\" id=\"field_jqcdy2_zip\" value=\"\" name=\"item_meta[551][zip]\"  data-reqmsg=\"What is your current mailing address? cannot be blank.\" aria-required=\"true\" data-invmsg=\"What is your current mailing address? is invalid\" aria-invalid=\"false\"   autocomplete=\"postal-code\" \/>\n\t<div class=\"frm_description\">Zip\/Postal<\/div><\/div>\n<div id=\"frm_field_551-country_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_jqcdy2_country\" class=\"frm_screen_reader frm_hidden\">\n\t\tCountry\t<\/label>\n\t\t\t<select name=\"item_meta[551][country]\" id=\"field_jqcdy2_country\"  data-reqmsg=\"What is your current mailing address? cannot be blank.\" aria-required=\"true\" data-invmsg=\"What is your current mailing address? is invalid\" aria-invalid=\"false\"   autocomplete=\"country-name\">\n\t\t\t<option value=\"\" class=\"\">\n\t\t\t\t \t\t\t<\/option>\n\t\t\t<option  value=\"Afghanistan\" data-code=\"AF\">Afghanistan<\/option><option  value=\"Aland Islands\" data-code=\"AX\">Aland Islands<\/option><option  value=\"Albania\" data-code=\"AL\">Albania<\/option><option  value=\"Algeria\" data-code=\"DZ\">Algeria<\/option><option  value=\"American Samoa\" data-code=\"AS\">American Samoa<\/option><option  value=\"Andorra\" data-code=\"AD\">Andorra<\/option><option  value=\"Angola\" data-code=\"AO\">Angola<\/option><option  value=\"Anguilla\" data-code=\"AI\">Anguilla<\/option><option  value=\"Antarctica\" data-code=\"AQ\">Antarctica<\/option><option  value=\"Antigua and Barbuda\" data-code=\"AG\">Antigua and Barbuda<\/option><option  value=\"Argentina\" data-code=\"AR\">Argentina<\/option><option  value=\"Armenia\" data-code=\"AM\">Armenia<\/option><option  value=\"Aruba\" data-code=\"AW\">Aruba<\/option><option  value=\"Australia\" data-code=\"AU\">Australia<\/option><option  value=\"Austria\" data-code=\"AT\">Austria<\/option><option  value=\"Azerbaijan\" data-code=\"AZ\">Azerbaijan<\/option><option  value=\"Bahamas\" data-code=\"BS\">Bahamas<\/option><option  value=\"Bahrain\" data-code=\"BH\">Bahrain<\/option><option  value=\"Bangladesh\" data-code=\"BD\">Bangladesh<\/option><option  value=\"Barbados\" data-code=\"BB\">Barbados<\/option><option  value=\"Belarus\" data-code=\"BY\">Belarus<\/option><option  value=\"Belgium\" data-code=\"BE\">Belgium<\/option><option  value=\"Belize\" data-code=\"BZ\">Belize<\/option><option  value=\"Benin\" data-code=\"BJ\">Benin<\/option><option  value=\"Bermuda\" data-code=\"BM\">Bermuda<\/option><option  value=\"Bhutan\" data-code=\"BT\">Bhutan<\/option><option  value=\"Bolivia\" data-code=\"BO\">Bolivia<\/option><option  value=\"Bonaire, Sint Eustatius and Saba\">Bonaire, Sint Eustatius and Saba<\/option><option  value=\"Bosnia and Herzegovina\" data-code=\"BA\">Bosnia and Herzegovina<\/option><option  value=\"Botswana\" data-code=\"BW\">Botswana<\/option><option  value=\"Bouvet Island\" data-code=\"BV\">Bouvet Island<\/option><option  value=\"Brazil\" data-code=\"BR\">Brazil<\/option><option  value=\"British Indian Ocean Territory\" data-code=\"IO\">British Indian Ocean Territory<\/option><option  value=\"Brunei\" data-code=\"BN\">Brunei<\/option><option  value=\"Bulgaria\" data-code=\"BG\">Bulgaria<\/option><option  value=\"Burkina Faso\" data-code=\"BF\">Burkina Faso<\/option><option  value=\"Burundi\" data-code=\"BI\">Burundi<\/option><option  value=\"C&ocirc;te d&#039;Ivoire\">C&ocirc;te d&#039;Ivoire<\/option><option  value=\"Cambodia\" data-code=\"KH\">Cambodia<\/option><option  value=\"Cameroon\" data-code=\"CM\">Cameroon<\/option><option  value=\"Canada\" data-code=\"CA\">Canada<\/option><option  value=\"Cape Verde\" data-code=\"CV\">Cape Verde<\/option><option  value=\"Cayman Islands\" data-code=\"KY\">Cayman Islands<\/option><option  value=\"Central African Republic\" data-code=\"CF\">Central African Republic<\/option><option  value=\"Chad\" data-code=\"TD\">Chad<\/option><option  value=\"Chile\" data-code=\"CL\">Chile<\/option><option  value=\"China\" data-code=\"CN\">China<\/option><option  value=\"Christmas Island\" data-code=\"CX\">Christmas Island<\/option><option  value=\"Cocos (Keeling) Islands\">Cocos (Keeling) Islands<\/option><option  value=\"Colombia\" data-code=\"CO\">Colombia<\/option><option  value=\"Comoros\" data-code=\"KM\">Comoros<\/option><option  value=\"Congo\">Congo<\/option><option  value=\"Cook Islands\" data-code=\"CK\">Cook Islands<\/option><option  value=\"Costa Rica\" data-code=\"CR\">Costa Rica<\/option><option  value=\"Croatia\" data-code=\"HR\">Croatia<\/option><option  value=\"Cuba\" data-code=\"CU\">Cuba<\/option><option  value=\"Curacao\" data-code=\"CW\">Curacao<\/option><option  value=\"Cyprus\" data-code=\"CY\">Cyprus<\/option><option  value=\"Czech Republic\" data-code=\"CZ\">Czech Republic<\/option><option  value=\"Denmark\" data-code=\"DK\">Denmark<\/option><option  value=\"Djibouti\" data-code=\"DJ\">Djibouti<\/option><option  value=\"Dominica\" data-code=\"DM\">Dominica<\/option><option  value=\"Dominican Republic\" data-code=\"DO\">Dominican Republic<\/option><option  value=\"East Timor\" data-code=\"TL\">East Timor<\/option><option  value=\"Ecuador\" data-code=\"EC\">Ecuador<\/option><option  value=\"Egypt\" data-code=\"EG\">Egypt<\/option><option  value=\"El Salvador\" data-code=\"SV\">El Salvador<\/option><option  value=\"Equatorial Guinea\" data-code=\"GQ\">Equatorial Guinea<\/option><option  value=\"Eritrea\" data-code=\"ER\">Eritrea<\/option><option  value=\"Estonia\" data-code=\"EE\">Estonia<\/option><option  value=\"Ethiopia\" data-code=\"ET\">Ethiopia<\/option><option  value=\"Falkland Islands (Malvinas)\">Falkland Islands (Malvinas)<\/option><option  value=\"Faroe Islands\" data-code=\"FO\">Faroe Islands<\/option><option  value=\"Fiji\" data-code=\"FJ\">Fiji<\/option><option  value=\"Finland\" data-code=\"FI\">Finland<\/option><option  value=\"France\" data-code=\"FR\">France<\/option><option  value=\"French Guiana\" data-code=\"GF\">French Guiana<\/option><option  value=\"French Polynesia\" data-code=\"PF\">French Polynesia<\/option><option  value=\"French Southern Territories\" data-code=\"TF\">French Southern Territories<\/option><option  value=\"Gabon\" data-code=\"GA\">Gabon<\/option><option  value=\"Gambia\" data-code=\"GM\">Gambia<\/option><option  value=\"Georgia\" data-code=\"GE\">Georgia<\/option><option  value=\"Germany\" data-code=\"DE\">Germany<\/option><option  value=\"Ghana\" data-code=\"GH\">Ghana<\/option><option  value=\"Gibraltar\" data-code=\"GI\">Gibraltar<\/option><option  value=\"Greece\" data-code=\"GR\">Greece<\/option><option  value=\"Greenland\" data-code=\"GL\">Greenland<\/option><option  value=\"Grenada\" data-code=\"GD\">Grenada<\/option><option  value=\"Guadeloupe\" data-code=\"GP\">Guadeloupe<\/option><option  value=\"Guam\" data-code=\"GU\">Guam<\/option><option  value=\"Guatemala\" data-code=\"GT\">Guatemala<\/option><option  value=\"Guernsey\" data-code=\"GG\">Guernsey<\/option><option  value=\"Guinea\" data-code=\"GN\">Guinea<\/option><option  value=\"Guinea-Bissau\" data-code=\"GW\">Guinea-Bissau<\/option><option  value=\"Guyana\" data-code=\"GY\">Guyana<\/option><option  value=\"Haiti\" data-code=\"HT\">Haiti<\/option><option  value=\"Heard Island and McDonald Islands\" data-code=\"HM\">Heard Island and McDonald Islands<\/option><option  value=\"Holy See\">Holy See<\/option><option  value=\"Honduras\" data-code=\"HN\">Honduras<\/option><option  value=\"Hong Kong\" data-code=\"HK\">Hong Kong<\/option><option  value=\"Hungary\" data-code=\"HU\">Hungary<\/option><option  value=\"Iceland\" data-code=\"IS\">Iceland<\/option><option  value=\"India\" data-code=\"IN\">India<\/option><option  value=\"Indonesia\" data-code=\"ID\">Indonesia<\/option><option  value=\"Iran\" data-code=\"IR\">Iran<\/option><option  value=\"Iraq\" data-code=\"IQ\">Iraq<\/option><option  value=\"Ireland\" data-code=\"IE\">Ireland<\/option><option  value=\"Isle of Man\" data-code=\"IM\">Isle of Man<\/option><option  value=\"Israel\" data-code=\"IL\">Israel<\/option><option  value=\"Italy\" data-code=\"IT\">Italy<\/option><option  value=\"Jamaica\" data-code=\"JM\">Jamaica<\/option><option  value=\"Japan\" data-code=\"JP\">Japan<\/option><option  value=\"Jersey\" data-code=\"JE\">Jersey<\/option><option  value=\"Jordan\" data-code=\"JO\">Jordan<\/option><option  value=\"Kazakhstan\" data-code=\"KZ\">Kazakhstan<\/option><option  value=\"Kenya\" data-code=\"KE\">Kenya<\/option><option  value=\"Kiribati\" data-code=\"KI\">Kiribati<\/option><option  value=\"Kosovo\" data-code=\"XK\">Kosovo<\/option><option  value=\"Kuwait\" data-code=\"KW\">Kuwait<\/option><option  value=\"Kyrgyzstan\" data-code=\"KG\">Kyrgyzstan<\/option><option  value=\"Laos\" data-code=\"LA\">Laos<\/option><option  value=\"Latvia\" data-code=\"LV\">Latvia<\/option><option  value=\"Lebanon\" data-code=\"LB\">Lebanon<\/option><option  value=\"Lesotho\" data-code=\"LS\">Lesotho<\/option><option  value=\"Liberia\" data-code=\"LR\">Liberia<\/option><option  value=\"Libya\" data-code=\"LY\">Libya<\/option><option  value=\"Liechtenstein\" data-code=\"LI\">Liechtenstein<\/option><option  value=\"Lithuania\" data-code=\"LT\">Lithuania<\/option><option  value=\"Luxembourg\" data-code=\"LU\">Luxembourg<\/option><option  value=\"Macao\" data-code=\"MO\">Macao<\/option><option  value=\"Macedonia\" data-code=\"MK\">Macedonia<\/option><option  value=\"Madagascar\" data-code=\"MG\">Madagascar<\/option><option  value=\"Malawi\" data-code=\"MW\">Malawi<\/option><option  value=\"Malaysia\" data-code=\"MY\">Malaysia<\/option><option  value=\"Maldives\" data-code=\"MV\">Maldives<\/option><option  value=\"Mali\" data-code=\"ML\">Mali<\/option><option  value=\"Malta\" data-code=\"MT\">Malta<\/option><option  value=\"Marshall Islands\" data-code=\"MH\">Marshall Islands<\/option><option  value=\"Martinique\" data-code=\"MQ\">Martinique<\/option><option  value=\"Mauritania\" data-code=\"MR\">Mauritania<\/option><option  value=\"Mauritius\" data-code=\"MU\">Mauritius<\/option><option  value=\"Mayotte\" data-code=\"YT\">Mayotte<\/option><option  value=\"Mexico\" data-code=\"MX\">Mexico<\/option><option  value=\"Micronesia\" data-code=\"FM\">Micronesia<\/option><option  value=\"Moldova\" data-code=\"MD\">Moldova<\/option><option  value=\"Monaco\" data-code=\"MC\">Monaco<\/option><option  value=\"Mongolia\" data-code=\"MN\">Mongolia<\/option><option  value=\"Montenegro\" data-code=\"ME\">Montenegro<\/option><option  value=\"Montserrat\" data-code=\"MS\">Montserrat<\/option><option  value=\"Morocco\" data-code=\"MA\">Morocco<\/option><option  value=\"Mozambique\" data-code=\"MZ\">Mozambique<\/option><option  value=\"Myanmar\" data-code=\"MM\">Myanmar<\/option><option  value=\"Namibia\" data-code=\"NA\">Namibia<\/option><option  value=\"Nauru\" data-code=\"NR\">Nauru<\/option><option  value=\"Nepal\" data-code=\"NP\">Nepal<\/option><option  value=\"Netherlands\" data-code=\"NL\">Netherlands<\/option><option  value=\"New Caledonia\" data-code=\"NC\">New Caledonia<\/option><option  value=\"New Zealand\" data-code=\"NZ\">New Zealand<\/option><option  value=\"Nicaragua\" data-code=\"NI\">Nicaragua<\/option><option  value=\"Niger\" data-code=\"NE\">Niger<\/option><option  value=\"Nigeria\" data-code=\"NG\">Nigeria<\/option><option  value=\"Niue\" data-code=\"NU\">Niue<\/option><option  value=\"Norfolk Island\" data-code=\"NF\">Norfolk Island<\/option><option  value=\"North Korea\" data-code=\"KP\">North Korea<\/option><option  value=\"Northern Mariana Islands\" data-code=\"MP\">Northern Mariana Islands<\/option><option  value=\"Norway\" data-code=\"NO\">Norway<\/option><option  value=\"Oman\" data-code=\"OM\">Oman<\/option><option  value=\"Pakistan\" data-code=\"PK\">Pakistan<\/option><option  value=\"Palau\" data-code=\"PW\">Palau<\/option><option  value=\"Palestine\">Palestine<\/option><option  value=\"Panama\" data-code=\"PA\">Panama<\/option><option  value=\"Papua New Guinea\" data-code=\"PG\">Papua New Guinea<\/option><option  value=\"Paraguay\" data-code=\"PY\">Paraguay<\/option><option  value=\"Peru\" data-code=\"PE\">Peru<\/option><option  value=\"Philippines\" data-code=\"PH\">Philippines<\/option><option  value=\"Pitcairn\" data-code=\"PN\">Pitcairn<\/option><option  value=\"Poland\" data-code=\"PL\">Poland<\/option><option  value=\"Portugal\" data-code=\"PT\">Portugal<\/option><option  value=\"Puerto Rico\" data-code=\"PR\">Puerto Rico<\/option><option  value=\"Qatar\" data-code=\"QA\">Qatar<\/option><option  value=\"Reunion\" data-code=\"RE\">Reunion<\/option><option  value=\"Romania\" data-code=\"RO\">Romania<\/option><option  value=\"Russia\" data-code=\"RU\">Russia<\/option><option  value=\"Rwanda\" data-code=\"RW\">Rwanda<\/option><option  value=\"Saint Barthelemy\" data-code=\"BL\">Saint Barthelemy<\/option><option  value=\"Saint Helena, Ascension and Tristan da Cunha\">Saint Helena, Ascension and Tristan da Cunha<\/option><option  value=\"Saint Kitts and Nevis\" data-code=\"KN\">Saint Kitts and Nevis<\/option><option  value=\"Saint Lucia\" data-code=\"LC\">Saint Lucia<\/option><option  value=\"Saint Martin (French part)\">Saint Martin (French part)<\/option><option  value=\"Saint Pierre and Miquelon\" data-code=\"PM\">Saint Pierre and Miquelon<\/option><option  value=\"Saint Vincent and the Grenadines\" data-code=\"VC\">Saint Vincent and the Grenadines<\/option><option  value=\"Samoa\" data-code=\"WS\">Samoa<\/option><option  value=\"San Marino\" data-code=\"SM\">San Marino<\/option><option  value=\"Sao Tome and Principe\" data-code=\"ST\">Sao Tome and Principe<\/option><option  value=\"Saudi Arabia\" data-code=\"SA\">Saudi Arabia<\/option><option  value=\"Senegal\" data-code=\"SN\">Senegal<\/option><option  value=\"Serbia\" data-code=\"RS\">Serbia<\/option><option  value=\"Seychelles\" data-code=\"SC\">Seychelles<\/option><option  value=\"Sierra Leone\" data-code=\"SL\">Sierra Leone<\/option><option  value=\"Singapore\" data-code=\"SG\">Singapore<\/option><option  value=\"Sint Maarten (Dutch part)\">Sint Maarten (Dutch part)<\/option><option  value=\"Slovakia\" data-code=\"SK\">Slovakia<\/option><option  value=\"Slovenia\" data-code=\"SI\">Slovenia<\/option><option  value=\"Solomon Islands\" data-code=\"SB\">Solomon Islands<\/option><option  value=\"Somalia\" data-code=\"SO\">Somalia<\/option><option  value=\"South Africa\" data-code=\"ZA\">South Africa<\/option><option  value=\"South Georgia and the South Sandwich Islands\" data-code=\"GS\">South Georgia and the South Sandwich Islands<\/option><option  value=\"South Korea\" data-code=\"KR\">South Korea<\/option><option  value=\"South Sudan\" data-code=\"SS\">South Sudan<\/option><option  value=\"Spain\" data-code=\"ES\">Spain<\/option><option  value=\"Sri Lanka\" data-code=\"LK\">Sri Lanka<\/option><option  value=\"Sudan\" data-code=\"SD\">Sudan<\/option><option  value=\"Suriname\" data-code=\"SR\">Suriname<\/option><option  value=\"Svalbard and Jan Mayen\" data-code=\"SJ\">Svalbard and Jan Mayen<\/option><option  value=\"Swaziland\" data-code=\"SZ\">Swaziland<\/option><option  value=\"Sweden\" data-code=\"SE\">Sweden<\/option><option  value=\"Switzerland\" data-code=\"CH\">Switzerland<\/option><option  value=\"Syria\" data-code=\"SY\">Syria<\/option><option  value=\"Taiwan\" data-code=\"TW\">Taiwan<\/option><option  value=\"Tajikistan\" data-code=\"TJ\">Tajikistan<\/option><option  value=\"Tanzania\" data-code=\"TZ\">Tanzania<\/option><option  value=\"Thailand\" data-code=\"TH\">Thailand<\/option><option  value=\"Timor-Leste\">Timor-Leste<\/option><option  value=\"Togo\" data-code=\"TG\">Togo<\/option><option  value=\"Tokelau\" data-code=\"TK\">Tokelau<\/option><option  value=\"Tonga\" data-code=\"TO\">Tonga<\/option><option  value=\"Trinidad and Tobago\" data-code=\"TT\">Trinidad and Tobago<\/option><option  value=\"Tunisia\" data-code=\"TN\">Tunisia<\/option><option  value=\"Turkey\" data-code=\"TR\">Turkey<\/option><option  value=\"Turkmenistan\" data-code=\"TM\">Turkmenistan<\/option><option  value=\"Turks and Caicos Islands\" data-code=\"TC\">Turks and Caicos Islands<\/option><option  value=\"Tuvalu\" data-code=\"TV\">Tuvalu<\/option><option  value=\"Uganda\" data-code=\"UG\">Uganda<\/option><option  value=\"Ukraine\" data-code=\"UA\">Ukraine<\/option><option  value=\"United Arab Emirates\" data-code=\"AE\">United Arab Emirates<\/option><option  value=\"United Kingdom\" data-code=\"GB\">United Kingdom<\/option><option  value=\"United States\" data-code=\"US\">United States<\/option><option  value=\"United States Minor Outlying Islands\" data-code=\"UM\">United States Minor Outlying Islands<\/option><option  value=\"Uruguay\" data-code=\"UY\">Uruguay<\/option><option  value=\"Uzbekistan\" data-code=\"UZ\">Uzbekistan<\/option><option  value=\"Vanuatu\" data-code=\"VU\">Vanuatu<\/option><option  value=\"Vatican City\">Vatican City<\/option><option  value=\"Venezuela\" data-code=\"VE\">Venezuela<\/option><option  value=\"Vietnam\" data-code=\"VN\">Vietnam<\/option><option  value=\"Virgin Islands, British\">Virgin Islands, British<\/option><option  value=\"Virgin Islands, U.S.\">Virgin Islands, U.S.<\/option><option  value=\"Wallis and Futuna\" data-code=\"WF\">Wallis and Futuna<\/option><option  value=\"Western Sahara\" data-code=\"EH\">Western Sahara<\/option><option  value=\"Yemen\" data-code=\"YE\">Yemen<\/option><option  value=\"Zambia\" data-code=\"ZM\">Zambia<\/option><option  value=\"Zimbabwe\" data-code=\"ZW\">Zimbabwe<\/option>\t\t<\/select>\n\t<div class=\"frm_description\">Country<\/div><\/div>\n<\/div>\n<\/fieldset>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_682_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label id=\"field_ak5tw_label\" class=\"frm_primary_label\" for=\"field_ak5tw\">Date of Birth\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_ak5tw\" name=\"item_meta[682]\" value=\"\"  data-reqmsg=\"Date of Birth cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_552_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio frm_other_container\">\r\n    <label class=\"frm_primary_label\" for=\"field_38eug2\">Year in School\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_radio\" id=\"frm_radio_552-0\">\t\t\t<label  for=\"field_38eug2-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[552]\" id=\"field_38eug2-0\" value=\"First Year\"\n\t\t data-reqmsg=\"Year in School cannot be blank.\" data-invmsg=\"Year in School is invalid\"   \/> First Year<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_552-1\">\t\t\t<label  for=\"field_38eug2-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[552]\" id=\"field_38eug2-1\" value=\"Sophomore\"\n\t\t data-reqmsg=\"Year in School cannot be blank.\" data-invmsg=\"Year in School is invalid\"   \/> Sophomore<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_552-2\">\t\t\t<label  for=\"field_38eug2-2\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[552]\" id=\"field_38eug2-2\" value=\"Junior\"\n\t\t data-reqmsg=\"Year in School cannot be blank.\" data-invmsg=\"Year in School is invalid\"   \/> Junior<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_552-3\">\t\t\t<label  for=\"field_38eug2-3\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[552]\" id=\"field_38eug2-3\" value=\"Senior\"\n\t\t data-reqmsg=\"Year in School cannot be blank.\" data-invmsg=\"Year in School is invalid\"   \/> Senior<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_552-4\">\t\t\t<label  for=\"field_38eug2-4\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[552]\" id=\"field_38eug2-4\" value=\"Graduate\"\n\t\t data-reqmsg=\"Year in School cannot be blank.\" data-invmsg=\"Year in School is invalid\"   \/> Graduate<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_552-other_5\">\t\t\t<label  for=\"field_38eug2-other_5\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[552]\" id=\"field_38eug2-other_5\" value=\"Other\"\n\t\t data-reqmsg=\"Year in School cannot be blank.\" data-invmsg=\"Year in School is invalid\"   \/> Other<\/label><label for=\"field_38eug2-other_5-otext\" class=\"frm_screen_reader frm_hidden\">Other<\/label><input type=\"text\" id=\"field_38eug2-other_5-otext\" class=\"frm_other_input frm_pos_none\"  name=\"item_meta[other][552]\" value=\"\" \/><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_587_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label id=\"field_smslz_label\" class=\"frm_primary_label\" for=\"field_smslz\">What is your major? \r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_smslz\" name=\"item_meta[587]\" value=\"\"  data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_553_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n    <label class=\"frm_primary_label\" for=\"field_z7tk92\">Are you a resident or a commuter?\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_radio\" id=\"frm_radio_553-0\">\t\t\t<label  for=\"field_z7tk92-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[553]\" id=\"field_z7tk92-0\" value=\"Resident\"\n\t\t data-reqmsg=\"Are you a resident or a commuter? cannot be blank.\" data-invmsg=\"Are you a resident or a commuter? is invalid\"   \/> Resident<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_553-1\">\t\t\t<label  for=\"field_z7tk92-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[553]\" id=\"field_z7tk92-1\" value=\"Commuter\"\n\t\t data-reqmsg=\"Are you a resident or a commuter? cannot be blank.\" data-invmsg=\"Are you a resident or a commuter? is invalid\"   \/> Commuter<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_554_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm_first vertical_radio\">\r\n    <label class=\"frm_primary_label\" for=\"field_pcafz2\">Are you an EOF student?\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_radio\" id=\"frm_radio_554-0\">\t\t\t<label  for=\"field_pcafz2-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[554]\" id=\"field_pcafz2-0\" value=\"Yes\"\n\t\t data-reqmsg=\"Are you an EOF student? cannot be blank.\" data-invmsg=\"Are you an EOF student? is invalid\"   \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_554-1\">\t\t\t<label  for=\"field_pcafz2-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[554]\" id=\"field_pcafz2-1\" value=\"No\"\n\t\t data-reqmsg=\"Are you an EOF student? cannot be blank.\" data-invmsg=\"Are you an EOF student? is invalid\"   \/> No<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_555_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n    <div id=\"field_co93x_label\" class=\"frm_primary_label\" for=\"field_co93x\">Are you an International Student\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_555-0\">\t\t\t<label  for=\"field_co93x-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[555]\" id=\"field_co93x-0\" value=\"Yes\"\n\t\t data-reqmsg=\"Are you an International Student cannot be blank.\" data-invmsg=\"Are you an International Student is invalid\"   \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_555-1\">\t\t\t<label  for=\"field_co93x-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[555]\" id=\"field_co93x-1\" value=\"No\"\n\t\t data-reqmsg=\"Are you an International Student cannot be blank.\" data-invmsg=\"Are you an International Student is invalid\"   \/> No<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_556_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio frm_other_container\">\r\n    <label class=\"frm_primary_label\" for=\"field_rd2m62\">Demographics\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_radio\" id=\"frm_radio_556-0\">\t\t\t<label  for=\"field_rd2m62-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[556]\" id=\"field_rd2m62-0\" value=\"American Indian or Alaska Native\"\n\t\t data-reqmsg=\"Demographics cannot be blank.\" data-invmsg=\"Demographics is invalid\"   \/> American Indian or Alaska Native<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_556-1\">\t\t\t<label  for=\"field_rd2m62-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[556]\" id=\"field_rd2m62-1\" value=\"Asian\"\n\t\t data-reqmsg=\"Demographics cannot be blank.\" data-invmsg=\"Demographics is invalid\"   \/> Asian<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_556-2\">\t\t\t<label  for=\"field_rd2m62-2\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[556]\" id=\"field_rd2m62-2\" value=\"Black or African American\"\n\t\t data-reqmsg=\"Demographics cannot be blank.\" data-invmsg=\"Demographics is invalid\"   \/> Black or African American<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_556-3\">\t\t\t<label  for=\"field_rd2m62-3\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[556]\" id=\"field_rd2m62-3\" value=\"Native Hawaiian or Other Pacific Islander\"\n\t\t data-reqmsg=\"Demographics cannot be blank.\" data-invmsg=\"Demographics is invalid\"   \/> Native Hawaiian or Other Pacific Islander<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_556-4\">\t\t\t<label  for=\"field_rd2m62-4\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[556]\" id=\"field_rd2m62-4\" value=\"White\"\n\t\t data-reqmsg=\"Demographics cannot be blank.\" data-invmsg=\"Demographics is invalid\"   \/> White<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_556-5\">\t\t\t<label  for=\"field_rd2m62-5\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[556]\" id=\"field_rd2m62-5\" value=\"Hispanic\"\n\t\t data-reqmsg=\"Demographics cannot be blank.\" data-invmsg=\"Demographics is invalid\"   \/> Hispanic<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_556-other_6\">\t\t\t<label  for=\"field_rd2m62-other_6\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[556]\" id=\"field_rd2m62-other_6\" value=\"Other\"\n\t\t data-reqmsg=\"Demographics cannot be blank.\" data-invmsg=\"Demographics is invalid\"   \/> Other<\/label><label for=\"field_rd2m62-other_6-otext\" class=\"frm_screen_reader frm_hidden\">Other<\/label><input type=\"text\" id=\"field_rd2m62-other_6-otext\" class=\"frm_other_input frm_pos_none\"  name=\"item_meta[other][556]\" value=\"\" \/><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_557_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label class=\"frm_primary_label\" for=\"field_bkd6k2\">Gender and Preferred Pronouns\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_bkd6k2\" name=\"item_meta[557]\" value=\"\"  data-reqmsg=\"Gender and Preferred Pronouns cannot be blank.\" aria-required=\"true\" data-invmsg=\"Gender is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_558_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n    <label class=\"frm_primary_label\" for=\"field_5gujp2\">Are you currently receiving any government funded means tested benefits? (e.g., SNAP, WIC, TANF, etc.)\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_radio\" id=\"frm_radio_558-0\">\t\t\t<label  for=\"field_5gujp2-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[558]\" id=\"field_5gujp2-0\" value=\"Yes\"\n\t\t data-reqmsg=\"Are you currently receiving any government funded means tested benefits? (e.g., SNAP, WIC, TANF, etc.) cannot be blank.\" data-invmsg=\"Are you currently receiving any government funded means tested benefits? (e.g., SNAP, WIC, TANF, etc.) is invalid\"   \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_558-1\">\t\t\t<label  for=\"field_5gujp2-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[558]\" id=\"field_5gujp2-1\" value=\"No\"\n\t\t data-reqmsg=\"Are you currently receiving any government funded means tested benefits? (e.g., SNAP, WIC, TANF, etc.) cannot be blank.\" data-invmsg=\"Are you currently receiving any government funded means tested benefits? (e.g., SNAP, WIC, TANF, etc.) is invalid\"   \/> No<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_735_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n\t<div  id=\"field_oqbso_label\" class=\"frm_primary_label\" for=\"field_oqbso\">Do you have any children or dependents?\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n\t<\/div>\r\n\t<div class=\"frm_opt_container\" aria-labelledby=\"field_oqbso_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_735-0\">\t\t\t<label  for=\"field_oqbso-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[735]\" id=\"field_oqbso-0\" value=\"Yes\"\n\t\t data-reqmsg=\"Do you have any children or dependents? cannot be blank.\" data-invmsg=\"Do you have any children or dependents? is invalid\"   \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_735-1\">\t\t\t<label  for=\"field_oqbso-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[735]\" id=\"field_oqbso-1\" value=\"No\"\n\t\t data-reqmsg=\"Do you have any children or dependents? cannot be blank.\" data-invmsg=\"Do you have any children or dependents? is invalid\"   \/> No<\/label><\/div>\n<\/div>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_559_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n    <div id=\"field_lk8ea_label\" class=\"frm_primary_label\" for=\"field_lk8ea\">Have you completed at least 8 credits at 缅北重口?\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_559-0\">\t\t\t<label  for=\"field_lk8ea-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[559]\" id=\"field_lk8ea-0\" value=\"Yes\"\n\t\t data-reqmsg=\"Have you completed at least 8 credits at 缅北重口? cannot be blank.\" data-invmsg=\"Have you completed at least 8 credits at 缅北重口? is invalid\"   \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_559-1\">\t\t\t<label  for=\"field_lk8ea-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[559]\" id=\"field_lk8ea-1\" value=\"No\"\n\t\t data-reqmsg=\"Have you completed at least 8 credits at 缅北重口? cannot be blank.\" data-invmsg=\"Have you completed at least 8 credits at 缅北重口? is invalid\"   \/> No<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_560_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio\">\r\n    <div id=\"field_hf8dg_label\" class=\"frm_primary_label\" for=\"field_hf8dg\">Will you have completed at least 8 credits by the end of this semester?\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" role=\"radiogroup\">\t\t<div class=\"frm_radio\" id=\"frm_radio_560-0\">\t\t\t<label  for=\"field_hf8dg-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[560]\" id=\"field_hf8dg-0\" value=\"Yes\"\n\t\t data-invmsg=\"Will you have completed at least 8 credits by the end of this semester? is invalid\"   \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_560-1\">\t\t\t<label  for=\"field_hf8dg-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[560]\" id=\"field_hf8dg-1\" value=\"No\"\n\t\t data-invmsg=\"Will you have completed at least 8 credits by the end of this semester? is invalid\"   \/> No<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_561_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n    <label class=\"frm_primary_label\" for=\"field_a0fxf2\">Are you a financial aid recipient?\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_radio\" id=\"frm_radio_561-0\">\t\t\t<label  for=\"field_a0fxf2-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[561]\" id=\"field_a0fxf2-0\" value=\"Yes\"\n\t\t data-reqmsg=\"Are you a financial aid recipient? cannot be blank.\" data-invmsg=\"Are you a financial aid recipient? is invalid\"   \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_561-1\">\t\t\t<label  for=\"field_a0fxf2-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[561]\" id=\"field_a0fxf2-1\" value=\"No\"\n\t\t data-reqmsg=\"Are you a financial aid recipient? cannot be blank.\" data-invmsg=\"Are you a financial aid recipient? is invalid\"   \/> No<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_562_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n    <label class=\"frm_primary_label\" for=\"field_sc05k2\">Did you receive a Financial Aid refund check?\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_radio\" id=\"frm_radio_562-0\">\t\t\t<label  for=\"field_sc05k2-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[562]\" id=\"field_sc05k2-0\" value=\"Yes\"\n\t\t data-reqmsg=\"Did you receive a Financial Aid refund check? cannot be blank.\" data-invmsg=\"Did you receive a Financial Aid refund check? is invalid\"   \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_562-1\">\t\t\t<label  for=\"field_sc05k2-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[562]\" id=\"field_sc05k2-1\" value=\"No\"\n\t\t data-reqmsg=\"Did you receive a Financial Aid refund check? cannot be blank.\" data-invmsg=\"Did you receive a Financial Aid refund check? is invalid\"   \/> No<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_685_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n\t<div  id=\"field_eu665_label\" class=\"frm_primary_label\" for=\"field_eu665\">Are you currently serving or have you previously served in the military? If not, are you a dependent or family member of someone who is or has served in the military?\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n\t<\/div>\r\n\t<div class=\"frm_opt_container\" aria-labelledby=\"field_eu665_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_685-0\">\t\t\t<label  for=\"field_eu665-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[685]\" id=\"field_eu665-0\" value=\"Yes\"\n\t\t data-reqmsg=\"Are you currently serving or have you previously served in the military? If not, are you a dependent or family member of someone who is or has served in the military? cannot be blank.\" data-invmsg=\"Are you currently serving or have you previously served in the military? If not, are you a dependent or family member of someone who is or has served in the military? is invalid\"   \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_685-1\">\t\t\t<label  for=\"field_eu665-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[685]\" id=\"field_eu665-1\" value=\"No\"\n\t\t data-reqmsg=\"Are you currently serving or have you previously served in the military? If not, are you a dependent or family member of someone who is or has served in the military? cannot be blank.\" data-invmsg=\"Are you currently serving or have you previously served in the military? If not, are you a dependent or family member of someone who is or has served in the military? is invalid\"   \/> No<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_685-2\">\t\t\t<label  for=\"field_eu665-2\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[685]\" id=\"field_eu665-2\" value=\"Prefer not to answer\"\n\t\t data-reqmsg=\"Are you currently serving or have you previously served in the military? If not, are you a dependent or family member of someone who is or has served in the military? cannot be blank.\" data-invmsg=\"Are you currently serving or have you previously served in the military? If not, are you a dependent or family member of someone who is or has served in the military? is invalid\"   \/> Prefer not to answer<\/label><\/div>\n<\/div>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_687_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n\t<label id=\"field_10p0s_label\" class=\"frm_primary_label\" for=\"field_10p0s\">Please describe your connection to the military or to a service member\/veteran (e.g., Active Duty, Reserve, Spouse, Dependent)\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n\t<\/label>\r\n\t<input  type=\"text\" id=\"field_10p0s\" name=\"item_meta[687]\" value=\"\"  data-invmsg=\"Please describe your connection to the military or to a service member\/veteran (e.g., Active Duty, Reserve, Spouse, Dependent) is invalid\" aria-invalid=\"false\"   \/>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_564_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label class=\"frm_primary_label\" for=\"field_dbypa2\">Describe the circumstances that led to your need.\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[564]\" id=\"field_dbypa2\" rows=\"10\"  data-reqmsg=\"Describe the circumstances that led to your need. cannot be blank.\" aria-required=\"true\" data-invmsg=\"Describe the circumstances that led to your need. is invalid\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_dbypa2\"><\/textarea>\r\n    <div id=\"frm_desc_field_dbypa2\" class=\"frm_description\">Please be as descriptive as possible and provide specific expenses if applicable<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_565_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm12 frm12 frm_first\">\r\n    <label class=\"frm_primary_label\" for=\"field_ai0292\">Where did you learn about the We Care Program? \r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[565]\" id=\"field_ai0292\" rows=\"5\"  data-reqmsg=\"Where did you learn about the We Care Program?  cannot be blank.\" aria-required=\"true\" data-invmsg=\"Where did you learn about the We Care Program?  is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_566_container\" class=\"frm_form_field form-field  frm_top_container frm12 frm_first\">\r\n    <label class=\"frm_primary_label\" for=\"g-recaptcha-response\">Security Check\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div  id=\"field_rsxgn2\" class=\"frm-g-recaptcha\" data-sitekey=\"6LcLSAkUAAAAAJjKKRs3gDlMiRQtsstKRYJpqVNz\" data-size=\"normal\" data-theme=\"light\"><\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_567_container\" class=\"frm_form_field  frm12 frm_first frm_html_container form-field\">\n<p>By submitting this form, you certify that all the information provided is accurate to the best of your knowledge. You are also granting professional staff members and Social Work Interns permission to review your financial aid, academic, and judicial standing.<\/p>\n<\/div>\n<div id=\"frm_field_683_container\" class=\"frm_form_field form-field \">\r\n\t<div class=\"frm_submit\">\r\n\r\n<button class=\"frm_button_submit\" type=\"submit\">Submit<\/button>\r\n\r\n<\/div>\r\n<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t<div id=\"frm_field_736_container\">\n\t\t\t<label for=\"field_4vm73\" >\n\t\t\t\tIf you are human, leave this field blank.\t\t\t<\/label>\n\t\t\t<input  id=\"field_4vm73\" type=\"text\" class=\"frm_form_field form-field frm_verify\" name=\"item_meta[736]\" value=\"\"  \/>\n\t\t<\/div>\n\t\t<input name=\"frm_state\" type=\"hidden\" value=\"k+CYyBtTPneG47muePQO32xQTEhqX8ixFByXUjzfIE96uIqtG6N4ulk4PEaUSIri\" \/><\/div>\n<\/fieldset>\n<\/div>\n\n<p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"ak_\"><label>&#916;<textarea name=\"ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"ak_js\" value=\"145\"\/><script>document.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );<\/script><\/p><\/form>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>The We Care Program is a campus-wide initiative, overseen by the Center for Student Involvement The We Care Program at 缅北重口 is comprised of: Food Pantry Laptop Upcycle Professional Clothing Closet Student Relief Fund Valley Health Fund For additional information about each individual program, please see the We Care Program home page In order [&hellip;]<\/p>\n","protected":false},"author":853,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1222","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v21.5 (Yoast SEO v27.1.1) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>We Care Program Application - Civic &amp; 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