1 <!--#include virtual="/server/2015/header.html"-->
3 <title>Scholarship Application
</title>
5 <!--#include virtual="/server/2015/banner.html"-->
6 <!--#include virtual="/server/2015/sidebar.html"-->
8 <h2>Scholarship Application
</h2>
10 <p style=
"font-weight: bold;">The official deadline for scholarship applications is passed. Please don't submit one unless the FSF asks you to.
</p>
12 <p>We are offering a limited number of travel scholarships to assist with expenses related to attending LibrePlanet. While we cannot offer stipends to everyone who applies, we will do our best to bring as many people as possible from as many communities as possible. We are generally unable to cover
100% of your travel and hotel costs, applicants should be prepared to cover some portion of travel expenses.
<strong>The application deadline for travel stipends is Sunday, November
30th,
2014 at
19:
59 EST (
23:
59 UTC).
</strong></p>
14 <p>One of the goals of our scholarship program is to increase participation by marginalized groups in our conference, so we ask some questions about identity. Remember that all of these fields are optional.
</p>
16 <form action=
"https://my.fsf.org/civicrm/profile/create?gid=334&reset=1" class=
"form-horizontal margin-top" method=
"post" name=
"Edit" id=
"Edit">
19 <input name=
"postURL" type=
"hidden"
20 value=
"https://libreplanet.org/2015/scholarships/confirmation.html" />
21 <input name=
"entryURL" type=
"hidden"
22 value=
"https://my.fsf.org/civicrm/profile/create?gid=334&reset=1/update?action=update&amp;id=334&amp;reset=1&amp;context=field" />
23 <input name=
"gid" type=
"hidden" value=
"334" />
24 <input name=
"_qf_default" type=
"hidden" value=
"Edit:cancel" />
28 <div class=
"crm-profile-name-GNU_30th_scholarship_application_334"> <!-- div 1 -->
30 <div id=
"crm-container" class=
"crm-container crm-public" lang=
"en" xml:
lang=
"en"> <!-- div 2 -->
32 <div id=
"editrow-first_name" class=
"form-group">
33 <label for=
"first_name" class=
"col-sm-3 control-label">
35 <span class=
"field-required">*
</span>
38 <div class=
"col-sm-5">
39 <input name=
"first_name" type=
"text" id=
"first_name" class=
"form-control" required
>
44 <div id=
"editrow-last_name" class=
"form-group">
45 <label for=
"last_name" class=
"control-label col-sm-3">
47 <span class=
"field-required">*
</span>
49 <div class=
"col-sm-5">
50 <input name=
"last_name" type=
"text" id=
"last_name" class=
"form-control" required
>
54 <div id=
"editrow-email-Primary" class=
"form-group">
55 <label for=
"email-Primary" class=
"control-label col-sm-3">Email
56 <span class=
"field-required">*
</span>
59 <div class=
"col-sm-5">
60 <input name=
"email-Primary" type=
"email" id=
"email-Primary" class=
"form-control" required
>
64 <div class=
"form-group">
65 <div class=
"col-sm-offset-3 col-sm-5" id=
"helprow-street_address-Primary">
66 <p class=
"help-block scholarship-input-annotation">
67 <small>Please tell us where you're coming from.
</small>
72 <div id=
"editrow-street_address-Primary" class=
"form-group">
73 <label for=
"street_address-Primary" class=
"col-sm-3 control-label">
74 Street Address
</label>
76 <div class=
"col-sm-5">
77 <input name=
"street_address-Primary" type=
"text" id=
"street_address-Primary" class=
"form-control" />
81 <div id=
"editrow-city-Primary" class=
"form-group">
82 <label class=
"col-sm-3 control-label" for=
"city-Primary">City
</label>
83 <div class=
"col-sm-5">
84 <input name=
"city-Primary" type=
"text" id=
"city-Primary" class=
"form-control" />
88 <div id=
"editrow-postal_code-Primary" class=
"form-group">
89 <label class=
"control-label col-sm-3" for=
"postal_code-Primary">
92 <div class=
"col-sm-5">
93 <input name=
"postal_code-Primary" type=
"number" id=
"postal_code-Primary" class=
"form-control" />
97 <div id=
"editrow-country-Primary" class=
"form-group">
98 <label class=
"control-label col-sm-3" for=
"country-Primary">
100 <span class=
"field-required">*
</span>
103 <div class=
"col-sm-5">
104 <select name=
"country-Primary" id=
"country-Primary" class=
"form-control">
105 <option value=
"">- select -
</option>
106 <option value=
"1228" selected=
"selected">United States
</option>
107 <option value=
"1001">Afghanistan
</option>
108 <option value=
"1241">Ă…land Islands
</option>
109 <option value=
"1002">Albania
</option>
110 <option value=
"1003">Algeria
</option>
111 <option value=
"1004">American Samoa
</option>
112 <option value=
"1005">Andorra
</option>
113 <option value=
"1006">Angola
</option>
114 <option value=
"1007">Anguilla
</option>
115 <option value=
"1008">Antarctica
</option>
116 <option value=
"1009">Antigua and Barbuda
</option>
117 <option value=
"1010">Argentina
</option>
118 <option value=
"1011">Armenia
</option>
119 <option value=
"1012">Aruba
</option>
120 <option value=
"1013">Australia
</option>
121 <option value=
"1014">Austria
</option>
122 <option value=
"1015">Azerbaijan
</option>
123 <option value=
"1212">Bahamas
</option>
124 <option value=
"1016">Bahrain
</option>
125 <option value=
"1017">Bangladesh
</option>
126 <option value=
"1018">Barbados
</option>
127 <option value=
"1019">Belarus
</option>
128 <option value=
"1020">Belgium
</option>
129 <option value=
"1021">Belize
</option>
130 <option value=
"1022">Benin
</option>
131 <option value=
"1023">Bermuda
</option>
132 <option value=
"1024">Bhutan
</option>
133 <option value=
"1025">Bolivia
</option>
134 <option value=
"1250">Bonaire, Saint Eustatius and Saba
</option>
135 <option value=
"1026">Bosnia and Herzegovina
</option>
136 <option value=
"1027">Botswana
</option>
137 <option value=
"1028">Bouvet Island
</option>
138 <option value=
"1029">Brazil
</option>
139 <option value=
"1030">British Indian Ocean Territory
</option>
140 <option value=
"1032">Brunei Darussalam
</option>
141 <option value=
"1033">Bulgaria
</option>
142 <option value=
"1034">Burkina Faso
</option>
143 <option value=
"1036">Burundi
</option>
144 <option value=
"1037">Cambodia
</option>
145 <option value=
"1038">Cameroon
</option>
146 <option value=
"1039">Canada
</option>
147 <option value=
"1040">Cape Verde
</option>
148 <option value=
"1041">Cayman Islands
</option>
149 <option value=
"1042">Central African Republic
</option>
150 <option value=
"1043">Chad
</option>
151 <option value=
"1044">Chile
</option>
152 <option value=
"1045">China
</option>
153 <option value=
"1046">Christmas Island
</option>
154 <option value=
"1047">Cocos (Keeling) Islands
</option>
155 <option value=
"1048">Colombia
</option>
156 <option value=
"1049">Comoros
</option>
157 <option value=
"1051">Congo, Republic of the
</option>
158 <option value=
"1050">Congo, The Democratic Republic of the
</option>
159 <option value=
"1052">Cook Islands
</option>
160 <option value=
"1053">Costa Rica
</option>
161 <option value=
"1054">CĂ´te d'Ivoire
</option>
162 <option value=
"1055">Croatia
</option>
163 <option value=
"1056">Cuba
</option>
164 <option value=
"1248">CuraĂƒÂ§ao
</option>
165 <option value=
"1057">Cyprus
</option>
166 <option value=
"1058">Czech Republic
</option>
167 <option value=
"1059">Denmark
</option>
168 <option value=
"1060">Djibouti
</option>
169 <option value=
"1061">Dominica
</option>
170 <option value=
"1062">Dominican Republic
</option>
171 <option value=
"1064">Ecuador
</option>
172 <option value=
"1065">Egypt
</option>
173 <option value=
"1066">El Salvador
</option>
174 <option value=
"1067">Equatorial Guinea
</option>
175 <option value=
"1068">Eritrea
</option>
176 <option value=
"1069">Estonia
</option>
177 <option value=
"1070">Ethiopia
</option>
178 <option value=
"1072">Falkland Islands (Malvinas)
</option>
179 <option value=
"1073">Faroe Islands
</option>
180 <option value=
"1074">Fiji
</option>
181 <option value=
"1075">Finland
</option>
182 <option value=
"1076">France
</option>
183 <option value=
"1077">French Guiana
</option>
184 <option value=
"1078">French Polynesia
</option>
185 <option value=
"1079">French Southern Territories
</option>
186 <option value=
"1080">Gabon
</option>
187 <option value=
"1213">Gambia
</option>
188 <option value=
"1081">Georgia
</option>
189 <option value=
"1082">Germany
</option>
190 <option value=
"1083">Ghana
</option>
191 <option value=
"1084">Gibraltar
</option>
192 <option value=
"1085">Greece
</option>
193 <option value=
"1086">Greenland
</option>
194 <option value=
"1087">Grenada
</option>
195 <option value=
"1088">Guadeloupe
</option>
196 <option value=
"1089">Guam
</option>
197 <option value=
"1090">Guatemala
</option>
198 <option value=
"1245">Guernsey
</option>
199 <option value=
"1091">Guinea
</option>
200 <option value=
"1092">Guinea-Bissau
</option>
201 <option value=
"1093">Guyana
</option>
202 <option value=
"1094">Haiti
</option>
203 <option value=
"1095">Heard Island and McDonald Islands
</option>
204 <option value=
"1096">Holy See (Vatican City State)
</option>
205 <option value=
"1097">Honduras
</option>
206 <option value=
"1098">Hong Kong
</option>
207 <option value=
"1099">Hungary
</option>
208 <option value=
"1100">Iceland
</option>
209 <option value=
"1101">India
</option>
210 <option value=
"1102">Indonesia
</option>
211 <option value=
"1103">Iran, Islamic Republic of
</option>
212 <option value=
"1104">Iraq
</option>
213 <option value=
"1105">Ireland
</option>
214 <option value=
"1246">Isle of Man
</option>
215 <option value=
"1106">Israel
</option>
216 <option value=
"1107">Italy
</option>
217 <option value=
"1108">Jamaica
</option>
218 <option value=
"1109">Japan
</option>
219 <option value=
"1244">Jersey
</option>
220 <option value=
"1110">Jordan
</option>
221 <option value=
"1111">Kazakhstan
</option>
222 <option value=
"1112">Kenya
</option>
223 <option value=
"1113">Kiribati
</option>
224 <option value=
"1114">Korea, Democratic People's Republic of
</option>
225 <option value=
"1115">Korea, Republic of
</option>
226 <option value=
"1251">Kosovo
</option>
227 <option value=
"1116">Kuwait
</option>
228 <option value=
"1117">Kyrgyzstan
</option>
229 <option value=
"1118">Lao People's Democratic Republic
</option>
230 <option value=
"1119">Latvia
</option>
231 <option value=
"1120">Lebanon
</option>
232 <option value=
"1121">Lesotho
</option>
233 <option value=
"1122">Liberia
</option>
234 <option value=
"1123">Libya
</option>
235 <option value=
"1124">Liechtenstein
</option>
236 <option value=
"1125">Lithuania
</option>
237 <option value=
"1126">Luxembourg
</option>
238 <option value=
"1127">Macao
</option>
239 <option value=
"1128">Macedonia, Republic of
</option>
240 <option value=
"1129">Madagascar
</option>
241 <option value=
"1130">Malawi
</option>
242 <option value=
"1131">Malaysia
</option>
243 <option value=
"1132">Maldives
</option>
244 <option value=
"1133">Mali
</option>
245 <option value=
"1134">Malta
</option>
246 <option value=
"1135">Marshall Islands
</option>
247 <option value=
"1136">Martinique
</option>
248 <option value=
"1137">Mauritania
</option>
249 <option value=
"1138">Mauritius
</option>
250 <option value=
"1139">Mayotte
</option>
251 <option value=
"1140">Mexico
</option>
252 <option value=
"1141">Micronesia, Federated States of
</option>
253 <option value=
"1142">Moldova
</option>
254 <option value=
"1143">Monaco
</option>
255 <option value=
"1144">Mongolia
</option>
256 <option value=
"1243">Montenegro
</option>
257 <option value=
"1145">Montserrat
</option>
258 <option value=
"1146">Morocco
</option>
259 <option value=
"1147">Mozambique
</option>
260 <option value=
"1035">Myanmar
</option>
261 <option value=
"1148">Namibia
</option>
262 <option value=
"1149">Nauru
</option>
263 <option value=
"1150">Nepal
</option>
264 <option value=
"1152">Netherlands
</option>
265 <option value=
"1153">New Caledonia
</option>
266 <option value=
"1154">New Zealand
</option>
267 <option value=
"1155">Nicaragua
</option>
268 <option value=
"1156">Niger
</option>
269 <option value=
"1157">Nigeria
</option>
270 <option value=
"1158">Niue
</option>
271 <option value=
"1159">Norfolk Island
</option>
272 <option value=
"1160">Northern Mariana Islands
</option>
273 <option value=
"1161">Norway
</option>
274 <option value=
"1162">Oman
</option>
275 <option value=
"1163">Pakistan
</option>
276 <option value=
"1164">Palau
</option>
277 <option value=
"1165">Palestinian Territory, Occupied
</option>
278 <option value=
"1166">Panama
</option>
279 <option value=
"1167">Papua New Guinea
</option>
280 <option value=
"1168">Paraguay
</option>
281 <option value=
"1169">Peru
</option>
282 <option value=
"1170">Philippines
</option>
283 <option value=
"1171">Pitcairn
</option>
284 <option value=
"1172">Poland
</option>
285 <option value=
"1173">Portugal
</option>
286 <option value=
"1174">Puerto Rico
</option>
287 <option value=
"1175">Qatar
</option>
288 <option value=
"1179">Reunion
</option>
289 <option value=
"1176">Romania
</option>
290 <option value=
"1177">Russian Federation
</option>
291 <option value=
"1178">Rwanda
</option>
292 <option value=
"1180">Saint Helena
</option>
293 <option value=
"1181">Saint Kitts and Nevis
</option>
294 <option value=
"1182">Saint Lucia
</option>
295 <option value=
"1183">Saint Pierre and Miquelon
</option>
296 <option value=
"1184">Saint Vincent and the Grenadines
</option>
297 <option value=
"1185">Samoa
</option>
298 <option value=
"1186">San Marino
</option>
299 <option value=
"1207">Sao Tome and Principe
</option>
300 <option value=
"1187">Saudi Arabia
</option>
301 <option value=
"1188">Senegal
</option>
302 <option value=
"1242">Serbia
</option>
303 <option value=
"1238">Serbia and Montenegro
</option>
304 <option value=
"1189">Seychelles
</option>
305 <option value=
"1190">Sierra Leone
</option>
306 <option value=
"1191">Singapore
</option>
307 <option value=
"1249">Sint Maarten (Dutch Part)
</option>
308 <option value=
"1192">Slovakia
</option>
309 <option value=
"1193">Slovenia
</option>
310 <option value=
"1194">Solomon Islands
</option>
311 <option value=
"1195">Somalia
</option>
312 <option value=
"1196">South Africa
</option>
313 <option value=
"1197">South Georgia and the South Sandwich Islands
</option>
314 <option value=
"1247">South Sudan
</option>
315 <option value=
"1198">Spain
</option>
316 <option value=
"1199">Sri Lanka
</option>
317 <option value=
"1200">Sudan
</option>
318 <option value=
"1201">Suriname
</option>
319 <option value=
"1202">Svalbard and Jan Mayen
</option>
320 <option value=
"1203">Swaziland
</option>
321 <option value=
"1204">Sweden
</option>
322 <option value=
"1205">Switzerland
</option>
323 <option value=
"1206">Syrian Arab Republic
</option>
324 <option value=
"1208">Taiwan
</option>
325 <option value=
"1209">Tajikistan
</option>
326 <option value=
"1210">Tanzania, United Republic of
</option>
327 <option value=
"1211">Thailand
</option>
328 <option value=
"1063">Timor-Leste
</option>
329 <option value=
"1214">Togo
</option>
330 <option value=
"1215">Tokelau
</option>
331 <option value=
"1216">Tonga
</option>
332 <option value=
"1217">Trinidad and Tobago
</option>
333 <option value=
"1218">Tunisia
</option>
334 <option value=
"1219">Turkey
</option>
335 <option value=
"1220">Turkmenistan
</option>
336 <option value=
"1221">Turks and Caicos Islands
</option>
337 <option value=
"1222">Tuvalu
</option>
338 <option value=
"1223">Uganda
</option>
339 <option value=
"1224">Ukraine
</option>
340 <option value=
"1225">United Arab Emirates
</option>
341 <option value=
"1226">United Kingdom
</option>
342 <option value=
"1227">United States Minor Outlying Islands
</option>
343 <option value=
"1229">Uruguay
</option>
344 <option value=
"1230">Uzbekistan
</option>
345 <option value=
"1231">Vanuatu
</option>
346 <option value=
"1232">Venezuela
</option>
347 <option value=
"1233">Viet Nam
</option>
348 <option value=
"1031">Virgin Islands, British
</option>
349 <option value=
"1234">Virgin Islands, U.S.
</option>
350 <option value=
"1235">Wallis and Futuna
</option>
351 <option value=
"1236">Western Sahara
</option>
352 <option value=
"1237">Yemen
</option>
353 <option value=
"1239">Zambia
</option>
354 <option value=
"1240">Zimbabwe
</option>
359 <div id=
"editrow-state_province-Primary" class=
"form-group">
360 <label class=
"control-label col-sm-3" for=
"state_province-Primary">State or Province
</label>
362 <div class=
"col-sm-5">
363 <select name=
"state_province-Primary" id=
"state_province-Primary" class=
"form-control">
364 <option value=
"">- select -
</option>
365 <option value=
"1000">Alabama
</option>
366 <option value=
"1001">Alaska
</option>
367 <option value=
"1052">American Samoa
</option>
368 <option value=
"1002">Arizona
</option>
369 <option value=
"1003">Arkansas
</option>
370 <option value=
"1060">Armed Forces Americas
</option>
371 <option value=
"1059">Armed Forces Europe
</option>
372 <option value=
"1061">Armed Forces Pacific
</option>
373 <option value=
"1004">California
</option>
374 <option value=
"1005">Colorado
</option>
375 <option value=
"1006">Connecticut
</option>
376 <option value=
"1007">Delaware
</option>
377 <option value=
"1050">District of Columbia
</option>
378 <option value=
"1008">Florida
</option>
379 <option value=
"1009">Georgia
</option>
380 <option value=
"1053">Guam
</option>
381 <option value=
"1010">Hawaii
</option>
382 <option value=
"1011">Idaho
</option>
383 <option value=
"1012">Illinois
</option>
384 <option value=
"1013">Indiana
</option>
385 <option value=
"1014">Iowa
</option>
386 <option value=
"1015">Kansas
</option>
387 <option value=
"1016">Kentucky
</option>
388 <option value=
"1017">Louisiana
</option>
389 <option value=
"1018">Maine
</option>
390 <option value=
"1019">Maryland
</option>
391 <option value=
"1020">Massachusetts
</option>
392 <option value=
"1021">Michigan
</option>
393 <option value=
"1022">Minnesota
</option>
394 <option value=
"1023">Mississippi
</option>
395 <option value=
"1024">Missouri
</option>
396 <option value=
"1025">Montana
</option>
397 <option value=
"1026">Nebraska
</option>
398 <option value=
"1027">Nevada
</option>
399 <option value=
"1028">New Hampshire
</option>
400 <option value=
"1029">New Jersey
</option>
401 <option value=
"1030">New Mexico
</option>
402 <option value=
"1031">New York
</option>
403 <option value=
"1032">North Carolina
</option>
404 <option value=
"1033">North Dakota
</option>
405 <option value=
"1055">Northern Mariana Islands
</option>
406 <option value=
"1034">Ohio
</option>
407 <option value=
"1035">Oklahoma
</option>
408 <option value=
"1036">Oregon
</option>
409 <option value=
"1037">Pennsylvania
</option>
410 <option value=
"1056">Puerto Rico
</option>
411 <option value=
"1038">Rhode Island
</option>
412 <option value=
"1039">South Carolina
</option>
413 <option value=
"1040">South Dakota
</option>
414 <option value=
"1041">Tennessee
</option>
415 <option value=
"1042">Texas
</option>
416 <option value=
"1058">United States Minor Outlying Islands
</option>
417 <option value=
"1043">Utah
</option>
418 <option value=
"1044">Vermont
</option>
419 <option value=
"1057">Virgin Islands
</option>
420 <option value=
"1045">Virginia
</option>
421 <option value=
"1046">Washington
</option>
422 <option value=
"1047">West Virginia
</option>
423 <option value=
"1048">Wisconsin
</option>
424 <option value=
"1049">Wyoming
</option>
429 <div class=
"form-group" id=
"helprow-state_province-Primary">
430 <div class=
"col-sm-offset-3 col-sm-9">
435 <div id=
"editrow-custom_199" class=
"form-group">
436 <label class=
"control-label col-sm-3" for=
"custom_199">Why do you want to attend LibrePlanet
2015?
</label>
437 <div class=
"col-sm-9">
438 <textarea rows=
"4" data-crm-custom=
"LP15_Scholarship:Why_do_you_want_to_attend_LibrePlanet_2015_"
439 name=
"custom_199" id=
"custom_199" class=
"form-control"></textarea>
443 <div class=
"form-group" id=
"helprow-custom_184">
444 <div class=
"col-sm-offset-3 col-sm-9">
445 <p class=
"help-block scholarship-input-annotation">
446 <small>We are working to increase the participation of marginalized
447 groups at LibrePlanet. Please share any identity information
448 you feel is important.
</small>
453 <div id=
"editrow-custom_184" class=
"form-group">
454 <label class=
"col-sm-3 control-label" for=
"custom_184">Gender
</label>
456 <div class=
"col-sm-5">
457 <input data-crm-custom=
"Identity_Free_Response:Gender" name=
"custom_184" type=
"text" id=
"custom_184" class=
"form-control" />
461 <div id=
"editrow-custom_185" class=
"form-group">
462 <label class=
"col-sm-3 control-label" for=
"custom_185">Race/Ethnicity
</label>
464 <div class=
"col-sm-5">
465 <input data-crm-custom=
"Identity_Free_Response:Race_Ethnicity" name=
"custom_185" type=
"text" id=
"custom_185" class=
"form-control" />
469 <div id=
"editrow-birth_date" class=
"form-group">
470 <label class=
"col-sm-3 control-label" for=
"birth_date_display">Birth Date
</label>
472 <div class=
"col-sm-5">
474 <input formattype=
"birth" startoffset=
"100" endoffset=
"0" format=
"mm/dd/yy"
475 name=
"birth_date" type=
"text" id=
"birth_date" class=
"form-text"
476 style=
"display: none;"/>
477 <input type=
"text" name=
"birth_date_display" id=
"birth_date_display"
478 class=
"form-control" autocomplete=
"off"/>
481 <a href=
"#" onclick=
"clearDateTime( 'birth_date' ); return false;">
488 <div class=
"form-group" id=
"helprow-custom_186">
489 <div class=
"col-sm-offset-3 col-sm-9"><p class=
"help-block scholarship-input-annotation"><small>A space for you to Include any other identity information that doesn't fit in the provided fields, like class background, ability/disability, national origin/citizenship status, sexuality, religion/spiritual practice, geography/regional affiliations, education, types of work, etc.
</small></p>
493 <div id=
"editrow-custom_186" class=
"form-group">
494 <label class=
"control-label col-sm-3" for=
"custom_186">
495 Anything else you'd like to tell us about yourself?
</label>
496 <div class=
"col-sm-9">
497 <textarea data-crm-custom=
"Identity_Free_Response:How_do_you_self_identify_"
498 rows=
"4" name=
"custom_186" id=
"custom_186"
499 class=
"form-control"></textarea>
503 <div id=
"editrow-custom_200" class=
"form-group">
505 <label class=
"control-label col-sm-3" for=
"custom_200">How do
506 you plan to bring your experience back to your
509 <div class=
"col-sm-9">
510 <textarea data-crm-custom=
"LP15_Scholarship:How_do_you_plan_to_bring_your_experience_back_to_your_community_"
511 rows=
"4" name=
"custom_200" id=
"custom_200" class=
"form-control"></textarea>
515 <div id=
"editrow-custom_203" class=
"form-group">
516 <label class=
"control-label col-sm-3" for=
"custom_203">
517 Estimated travel and hotel expenses
519 <div class=
"col-sm-9">
520 <textarea data-crm-custom=
"LP15_Scholarship:Estimated_travel_and_hotel_expenses" rows=
"4"
521 name=
"custom_203" id=
"custom_203" class=
"form-control"></textarea>
525 <!-- <div id="editrow-custom_204" class="form-group">
526 <label class="control-label col-sm-3" for="custom_204">
527 Are there any special accommodations that would make it easier for you to attend LibrePlanet?
529 <div class="col-sm-9">
530 <textarea data-crm-custom="LP15_Scholarship:Are_there_any_special_accommodations_that_would_make_it_easier_f" rows="4"
531 name="custom_204" id="custom_204" class="form-control"></textarea>
532 <span class="help-block">Examples: ASL interpretation, wheelchair accessibility, etc.</span>
536 <div id="editrow-custom_205" class="form-group">
537 <label class="control-label col-sm-3">Would you be willing to volunteer at the event?</label>
539 <div class="col-sm-5">
540 <label class="radio-inline" for="CIVICRM_QFID_1_2">
541 <input data-crm-custom="LP15_Scholarship:Would_you_be_willing_to_volunteer_at_the_event_"
542 value="1" type="radio" id="CIVICRM_QFID_1_2" name="custom_205" />
546 <label class="radio-inline" for="CIVICRM_QFID_0_4">
547 <input data-crm-custom="LP15_Scholarship:Would_you_be_willing_to_volunteer_at_the_event_"
548 value="0" type="radio" id="CIVICRM_QFID_0_4" name="custom_205" />No
551 <span class="radio-clear-link">(<a href="#" title="unselect" onclick="unselectRadio('custom_205', 'Edit'); return false;">clear</a>)</span>
556 <div id=
"editrow-custom_206" class=
"form-group">
557 <label class=
"control-label col-sm-3">Are you a student?
</label>
559 <div class=
"col-sm-5">
560 <label class=
"radio-inline" for=
"CIVICRM_QFID_1_6">
561 <input data-crm-custom=
"LP15_Scholarship:Are_you_a_student_"
562 value=
"1" type=
"radio" id=
"CIVICRM_QFID_1_6" name=
"custom_206" />
566 <label class=
"radio-inline" for=
"CIVICRM_QFID_0_8">
567 <input data-crm-custom=
"LP15_Scholarship:Are_you_a_student_" value=
"0"
568 type=
"radio" id=
"CIVICRM_QFID_0_8" name=
"custom_206" />No
571 <span class=
"radio-clear-link">
572 <a href=
"#" title=
"unselect" onclick=
"unselectRadio('custom_206', 'Edit'); return false;">clear
</a>
577 <div id=
"editrow-custom_207" class=
"form-group">
578 <label class=
"control-label col-sm-3" for=
"custom_207">Free software project affiliation, if any
</label>
580 <div class=
"col-sm-5">
581 <input data-crm-custom=
"LP15_Scholarship:Free_software_project_affiliation_if_any"
582 name=
"custom_207" type=
"text" id=
"custom_207" class=
"form-control" />
586 <div class=
"form-group">
587 <div class=
"col-sm-12">
589 We will not publish or share
590 your information with any party outside the FSF. See our
591 <a href=
"https://my.fsf.org/donate/privacypolicy.html">
592 privacy policy
</a> for more information.
597 <div class=
"form-group">
598 <div class=
"col-sm-12">
600 <input class=
"btn btn-default" accesskey=
"S" name=
"_qf_Edit_next" value=
"Save" type=
"submit" id=
"_qf_Edit_next" />
601 <!-- <input onclick="location.href='https://my.fsf.org/civicrm/profile?reset=1&gid=334'; return false;" class="cancel form-submit default" name="_qf_Edit_cancel" value="Cancel" type="submit" id="_qf_Edit_cancel" /> -->
610 <!--#include virtual="/server/2015/footer.html"-->
611 <!--#include virtual="/server/2015/scholarship_js.html"-->
613 <!--#include virtual="/server/2015/close.html" -->